Provider Demographics
NPI:1215997853
Name:ENOS HOME OXYGEN THERAPY, INC.
Entity type:Organization
Organization Name:ENOS HOME OXYGEN THERAPY, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:ENOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-992-2146
Mailing Address - Street 1:PO BOX 8756
Mailing Address - Street 2:
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02742-8756
Mailing Address - Country:US
Mailing Address - Phone:508-992-2146
Mailing Address - Fax:508-999-2724
Practice Address - Street 1:35 WELBY RD
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02745-1118
Practice Address - Country:US
Practice Address - Phone:508-992-2146
Practice Address - Fax:508-999-2724
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-27
Last Update Date:2012-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1535129Medicaid
MA1535129Medicaid