Professional Home Care Dearborn Oxygen Therapy Co

NPI #1720072812 in Dearborn, Michigan

Provider Information

NPI Number: 1720072812
Entity Type: Organization
Organization Name: Professional Home Care Dearborn Oxygen Therapy Co
Primary Specialty: Department of Veterans Affairs (VA) Pharmacy
Enumeration Date: Sep 6, 2005
Last Updated: Jan 12, 2012

Practice Location

Address: 24706 MICHIGAN AVE
City: Dearborn
State: Michigan
ZIP Code: 48124-1750
Phone: (313) 277-2160

Authorized Official

Name: MR. BRIAN G KOLFAGE
Title: PRESIDENT
Phone: (313) 277-2160

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Durable Medical Equipment & Medical Supplies - Oxygen Equipment & Supplies — Oxygen Equipment & Supplies	332BX2000X
Department of Veterans Affairs (VA) Pharmacy	332100000X	Primary

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