Provider Demographics
NPI:1891867354
Name:OXYGEN RICH, LLC
Entity type:Organization
Organization Name:OXYGEN RICH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:CLAUDE
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIESLAND
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:318-746-6628
Mailing Address - Street 1:1509 DOCTORS DR
Mailing Address - Street 2:
Mailing Address - City:BOSSIER CITY
Mailing Address - State:LA
Mailing Address - Zip Code:71111-3321
Mailing Address - Country:US
Mailing Address - Phone:318-746-6288
Mailing Address - Fax:318-746-7911
Practice Address - Street 1:805 KINGS WAY
Practice Address - Street 2:
Practice Address - City:WAKE VILLAGE
Practice Address - State:TX
Practice Address - Zip Code:75501-5775
Practice Address - Country:US
Practice Address - Phone:903-831-7424
Practice Address - Fax:903-831-2384
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXATP3803332BC3200X
TX0092873332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR163593716Medicaid
TX185354102Medicaid
TX185354101Medicaid
TX5847080001Medicare NSC