Provider Demographics
NPI:1205912227
Name:DEPENDABLE OXYGEN COMPANY INC
Entity type:Organization
Organization Name:DEPENDABLE OXYGEN COMPANY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LUANNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DYE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:801-253-4522
Mailing Address - Street 1:63 E 1280 N
Mailing Address - Street 2:
Mailing Address - City:TOOELE
Mailing Address - State:UT
Mailing Address - Zip Code:84074-8120
Mailing Address - Country:US
Mailing Address - Phone:435-882-0005
Mailing Address - Fax:
Practice Address - Street 1:63 E 1280 N
Practice Address - Street 2:
Practice Address - City:TOOELE
Practice Address - State:UT
Practice Address - Zip Code:84074-2101
Practice Address - Country:US
Practice Address - Phone:435-882-0055
Practice Address - Fax:435-882-3766
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-31
Last Update Date:2009-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT1205912227Medicaid
5974090001Medicare NSC