| Organization Name: | THE OXYGEN STORE, INC. |
| NPI Number: | 1740433739 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DELOS YANCEY (OWNER) |
| Mailing Address: | 8804a Dayton Pike Soddy Daisy |
| State: | TN US |
| Postal Code: | 373794306 |
| Phone Number: | 4234510515 |
| Fax Number: | 4234510516 |
| NPI Enumeration Date: | 11/04/2008 |
| NPI Last Update Date: | 11/04/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BX2000X |
| License Number: | 0000000926 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Oxygen Equipment & Supplies |
| Taxonomy Definition: | |