Provider Demographics
NPI:1538850995
Name:HOMETOWN OXYGEN CHARLOTTE LLC
Entity type:Organization
Organization Name:HOMETOWN OXYGEN CHARLOTTE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF REIMBURSEMENT
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:MAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-692-2745
Mailing Address - Street 1:41 SPRING ST STE 103
Mailing Address - Street 2:
Mailing Address - City:NEW PROVIDENCE
Mailing Address - State:NJ
Mailing Address - Zip Code:07974-1143
Mailing Address - Country:US
Mailing Address - Phone:732-692-2745
Mailing Address - Fax:
Practice Address - Street 1:2205 MERCANTILE DRIVE NE
Practice Address - Street 2:SUITE 2
Practice Address - City:LELAND
Practice Address - State:NC
Practice Address - Zip Code:28451
Practice Address - Country:US
Practice Address - Phone:888-902-3502
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOMETOWN OXYGEN CHARLOTTE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-05-17
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies