Provider Demographics
NPI:1003981010
Name:CHANDLER SCOTT EDWARDS
Entity Type:Organization
Organization Name:CHANDLER SCOTT EDWARDS
Other - Org Name:OXYCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL MANAGER CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:BETH
Authorized Official - Last Name:STALLSMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-798-8021
Mailing Address - Street 1:1758 E ANDREW JOHNSON HWY
Mailing Address - Street 2:
Mailing Address - City:GREENEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37745-4278
Mailing Address - Country:US
Mailing Address - Phone:423-798-8021
Mailing Address - Fax:423-798-8023
Practice Address - Street 1:1758 E ANDREW JOHNSON HWY
Practice Address - Street 2:
Practice Address - City:GREENEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37745-4278
Practice Address - Country:US
Practice Address - Phone:423-798-8021
Practice Address - Fax:423-798-8023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-22
Last Update Date:2009-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPPLIED FOR 11-22-06332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1455162Medicaid
TN4159565OtherBLUECROSS BLUESHIELD
TN5876960001Medicare NSC