Provider Demographics
NPI:1992799019
Name:RKR OXYGEN & SUPPLIES INC
Entity type:Organization
Organization Name:RKR OXYGEN & SUPPLIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:Y
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-766-2119
Mailing Address - Street 1:1270 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEBURG
Mailing Address - State:TN
Mailing Address - Zip Code:38464-2762
Mailing Address - Country:US
Mailing Address - Phone:931-766-2119
Mailing Address - Fax:931-548-0705
Practice Address - Street 1:1270 1ST AVE
Practice Address - Street 2:
Practice Address - City:LAWRENCEBURG
Practice Address - State:TN
Practice Address - Zip Code:38464-2762
Practice Address - Country:US
Practice Address - Phone:931-766-2119
Practice Address - Fax:931-548-0705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-02
Last Update Date:2011-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000000834332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
002005520OtherBLUE CROSS BLUE SHIELD TN
TN3562699Medicaid
357951400OtherOWCP DOL
0309100001Medicare NSC