Provider Demographics
NPI:1174900633
Name:SUPERIOR OXYGEN AND MEDICAL SUPPLY, INC.
Entity type:Organization
Organization Name:SUPERIOR OXYGEN AND MEDICAL SUPPLY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:C
Authorized Official - Last Name:BYERLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-371-0202
Mailing Address - Street 1:438 N DUKE ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-4927
Mailing Address - Country:US
Mailing Address - Phone:717-509-0202
Mailing Address - Fax:717-509-0205
Practice Address - Street 1:438 N DUKE ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-4927
Practice Address - Country:US
Practice Address - Phone:717-509-0202
Practice Address - Fax:717-509-0205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-04
Last Update Date:2016-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies