Provider Demographics
NPI:1861193757
Name:HOME OXYGEN COMPANY, INC
Entity type:Organization
Organization Name:HOME OXYGEN COMPANY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:EWERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-523-0202
Mailing Address - Street 1:PO BOX 578173
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95357-8173
Mailing Address - Country:US
Mailing Address - Phone:209-523-0202
Mailing Address - Fax:888-499-0202
Practice Address - Street 1:5039 PENTECOST DR STE C
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95356-9290
Practice Address - Country:US
Practice Address - Phone:209-523-0202
Practice Address - Fax:888-499-0202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-16
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies