Provider Demographics
NPI:1508828955
Name:VMS HOME OXYGEN, INC.
Entity Type:Organization
Organization Name:VMS HOME OXYGEN, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:MISTY
Authorized Official - Middle Name:D
Authorized Official - Last Name:SHANER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-892-9286
Mailing Address - Street 1:1004B W CUMBERLAND ST
Mailing Address - Street 2:
Mailing Address - City:DUNN
Mailing Address - State:NC
Mailing Address - Zip Code:28334-4716
Mailing Address - Country:US
Mailing Address - Phone:910-892-9286
Mailing Address - Fax:910-892-1767
Practice Address - Street 1:1004B W CUMBERLAND ST
Practice Address - Street 2:
Practice Address - City:DUNN
Practice Address - State:NC
Practice Address - Zip Code:28334-4716
Practice Address - Country:US
Practice Address - Phone:910-892-9286
Practice Address - Fax:910-892-1767
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-03
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13310332BX2000X
NC01501 (BDP)332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7702028Medicaid
NC045GXOtherBCBS PROVIDER ID
1160930001Medicare PIN
NC045GXOtherBCBS PROVIDER ID