Provider Demographics
NPI:1285916528
Name:ENOS HOME OXYGEN THERAPY INC
Entity type:Organization
Organization Name:ENOS HOME OXYGEN THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
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 1:35 WELBY RD
Mailing Address - Street 2:
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02745-1118
Mailing Address - Country:US
Mailing Address - Phone:508-992-2146
Mailing Address - Fax:508-999-2724
Practice Address - Street 1:1275 FALL RIVER AVE
Practice Address - Street 2:
Practice Address - City:SEEKONK
Practice Address - State:MA
Practice Address - Zip Code:02771-5905
Practice Address - Country:US
Practice Address - Phone:508-557-0043
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-13
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0123950001Medicare PIN