Provider Demographics
NPI:1467480467
Name:OXYGEN AND RESPIRATORY CARE
Entity Type:Organization
Organization Name:OXYGEN AND RESPIRATORY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:SPROUSE
Authorized Official - Suffix:
Authorized Official - Credentials:RRT
Authorized Official - Phone:615-868-7118
Mailing Address - Street 1:PO BOX 980
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:TN
Mailing Address - Zip Code:37116-0980
Mailing Address - Country:US
Mailing Address - Phone:615-868-7118
Mailing Address - Fax:615-868-2074
Practice Address - Street 1:7 COOK ST STE B
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:TN
Practice Address - Zip Code:38583-1590
Practice Address - Country:US
Practice Address - Phone:931-836-3257
Practice Address - Fax:931-836-3258
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-29
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000000469332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN020478OtherBLUE CROSS BLUE SHIELD
TN3542761Medicaid
TN3542761Medicaid