Provider Demographics
NPI:1306336268
Name:MOUNTAIN OXYGEN & MEDICAL SUPPLIES INC.
Entity type:Organization
Organization Name:MOUNTAIN OXYGEN & MEDICAL SUPPLIES INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:RATZLAFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-390-6335
Mailing Address - Street 1:PO BOX 327
Mailing Address - Street 2:
Mailing Address - City:MINTURN
Mailing Address - State:CO
Mailing Address - Zip Code:81645-0327
Mailing Address - Country:US
Mailing Address - Phone:970-524-1181
Mailing Address - Fax:970-300-1813
Practice Address - Street 1:486 PINE ST.
Practice Address - Street 2:
Practice Address - City:MINTURN
Practice Address - State:CO
Practice Address - Zip Code:81645
Practice Address - Country:US
Practice Address - Phone:970-524-1181
Practice Address - Fax:970-300-1813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-16
Last Update Date:2018-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO20186000426OtherCOLORADO DURABLE MEDICAL EQUIPMENT SUPPLIER