MAVERICK OXYGEN & RESPIRATORY EQUIPMENT, LLC (NPI# 1609020221) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609020221 |
| Entity Type | Organization |
| Organization Name | MAVERICK OXYGEN & RESPIRATORY EQUIPMENT, LLC |
| Other Organization Name | MAVERICK GROUP, LLC |
| Practice Address |
2510 Allen Ln La Grange KY 40031-8580 |
| Practice Telephone | 5022254772 |
| Practice Fax Number | 5022250605 |
| Mailing Telephone | 5022254772 |
| Mailing Fax Number | 5022250605 |
| Enumeration Date | 2008-11-10 |
| Last Update Date | 2008-11-10 |
| Authorized Official Name | MR. SCOTT KITTLESON (PRESIDENT/OWNER) |
| Authorized Official Telephone | 5022254772 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332BX2000X |
Durable Medical Equipment & Medical Supplies Specialization: Oxygen Equipment & Supplies |
MG0450 | KY | Suppliers |
| Other Name | Type Code |
|---|---|
| Maverick Group, LLC | Former Legal Business Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | MAVERICK OXYGEN & RESPIRATORY EQUIPMENT, LLC | 2510 Allen Ln, La Grange, KY 40031-8580 |
| Indiana Business Entities | MAVERICK OXYGEN & RESPIRATORY EQUIPMENT, LLC | 2510 Allen Lane, La Grange, KY 40031 |
| Street Address |
2510 ALLEN LN |
| City | LA GRANGE |
| State | KY |
| Zip Code | 40031-8580 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245723089 | Nancee L Berling | Registered Nurse | 1914 Miller Ln, La Grange, KY 40031 | 2018-06-06 |
| 1134643000 | Zachary Byrne | Dentist | 3108 S. Hwy 53, Lagrange, KY 40031 | 2017-08-01 |
| 1609399971 | Walgreen Co | Pharmacy | 408 Oldham Plaza, La Grange, KY 40031 | 2017-07-19 |
| 1447790886 | Carolyn Marie Burton | Speech-Language Pathologist | 4603 Timber Walk Ct., Lagrange, KY 40031 | 2017-03-05 |
| 1699145466 | Janet Frager | Nurse Practitioner | 1023 New Moody Ln Ste 101, La Grange, KY 40031 | 2015-10-05 |
| 1730559188 | Amanda Lynn Drawbaugh | Physical Therapist | Ascb Therapy, 4603 Timber Walk Ct., Lagrange, KY 40031 | 2015-09-29 |
| 1407250483 | Aaron Mangum | Specialist/Technologist | 2850 Jericho Road, Lagrange, KY 40031 | 2014-10-20 |
| 1073944500 | Tamara Thomas | Case Manager/Care Coordinator | 4121 Spencer Ct, Lagrange, KY 40031 | 2013-12-10 |
| 1669643854 | Alisa Marie Skinner | Physical Therapist | 618 Kentucky Ave, Lagrange, KY 40031 | 2008-03-17 |
| 1245410711 | Jennifer Lee Thomas | Nurse Practitioner | 1015 New Moody Lane, Lagrange, KY 40031 | 2007-11-13 |
| Find all providers in zip 40031 | ||||
| Taxonomy Code | 332BX2000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| Specialization | Oxygen Equipment & Supplies |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144676834 | Butterfield Health Care Vii, LLC | Durable Medical Equipment & Medical Supplies | 339 9th Ave, La Grange, IL 60525-6429 | 2016-05-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952948002 | Alexandria Durable Medical Equipment, LLC | Durable Medical Equipment & Medical Supplies | 8242 Alexandria Pike Ste 100, Alexandria, KY 41001-1162 | 2019-12-09 |
| 1467923011 | Medical Service Companies | Durable Medical Equipment & Medical Supplies | 1313 Lyndon Ln Ste 108, Louisville, KY 40222-7301 | 2018-12-07 |
| 1760964514 | Ephraim Mcdowell Regional Medical Center, Incorporated | Durable Medical Equipment & Medical Supplies | 470 Linden Ave Ste 1, Harrodsburg, KY 40330 | 2018-08-29 |
| 1730680307 | Max Medical Equipment, Inc. | Durable Medical Equipment & Medical Supplies | 207 E Madison St, Louisa, KY 41230-1402 | 2018-02-28 |
| 1871035501 | All American Oxygen, Inc | Durable Medical Equipment & Medical Supplies | 359 Skidmore Dr, Harlan, KY 40831-2544 | 2016-11-11 |
| 1285183707 | Greene Respiratory Services, Inc. | Durable Medical Equipment & Medical Supplies | 6301 Poplar Tree Ct, Louisville, KY 40228-1076 | 2016-09-26 |
| 1417321019 | Wecare Medical, LLC | Durable Medical Equipment & Medical Supplies | 2644 Richmond Rd, Lexington, KY 40509-1501 | 2015-11-19 |
| 1518338276 | Orr Medical, LLC . | Durable Medical Equipment & Medical Supplies | 408 Newman Dr, Eddyville, KY 42038-7734 | 2015-10-07 |
| 1477939387 | Genesis Respiratory Services Inc | Durable Medical Equipment & Medical Supplies | 832 Winchester Ave, Ashland, KY 41101-7445 | 2015-08-03 |
| 1396175709 | Wecare Medical Somerset, LLC | Durable Medical Equipment & Medical Supplies | 209 London Shopping Ctr, London, KY 40741-3016 | 2013-11-21 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.