Provider Demographics
NPI:1992737340
Name:OXY-CARE EQUIPMENT COMPANY
Entity type:Organization
Organization Name:OXY-CARE EQUIPMENT COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CLARK
Authorized Official - Middle Name:A
Authorized Official - Last Name:ROBICHAUX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-392-6659
Mailing Address - Street 1:PO BOX 4822
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28406-1822
Mailing Address - Country:US
Mailing Address - Phone:910-392-6659
Mailing Address - Fax:910-392-6693
Practice Address - Street 1:3502 WRIGHTSVILLE AVE
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-4190
Practice Address - Country:US
Practice Address - Phone:910-393-6659
Practice Address - Fax:910-392-6693
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-07
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC980508332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC04948OtherBLUE CROSS & BLUE SHIELD
NC7700011Medicaid
NC04948OtherBLUE CROSS & BLUE SHIELD
NC7700011Medicaid