| Organization Name: | ELLIS HOME OXYGEN AND MEDICAL EQUIPMENT |
| NPI Number: | 1154452555 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ANTHONY ELLIS (PRESIDENT) |
| Mailing Address: | 2460 Lee Hwy Suite 7 Pulaski |
| State: | VA US |
| Postal Code: | 24301 |
| Phone Number: | 5409809551 |
| Fax Number: | 5409809553 |
| NPI Enumeration Date: | 03/08/2007 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BX2000X |
| License Number: | 0206009243 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Oxygen Equipment & Supplies |
| Taxonomy Definition: | |