Provider Demographics
NPI:1043357148
Name:OXYGEN SERVICES OF AMERICA LLC
Entity type:Organization
Organization Name:OXYGEN SERVICES OF AMERICA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MATT
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-743-5000
Mailing Address - Street 1:731 N MAIN ST STE A
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:AR
Mailing Address - Zip Code:72601-2912
Mailing Address - Country:US
Mailing Address - Phone:870-743-5000
Mailing Address - Fax:870-743-0002
Practice Address - Street 1:731 N MAIN ST STE A
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:AR
Practice Address - Zip Code:72601-2912
Practice Address - Country:US
Practice Address - Phone:870-743-5000
Practice Address - Fax:870-743-0002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
5364110001Medicare ID - Type Unspecified