Provider Demographics
NPI:1568445765
Name:SEIBERS DME & OXYGEN
Entity Type:Organization
Organization Name:SEIBERS DME & OXYGEN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JIMMY
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:SEIBERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-474-7208
Mailing Address - Street 1:PO BOX 7101
Mailing Address - Street 2:
Mailing Address - City:MC MINNVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37111-7101
Mailing Address - Country:US
Mailing Address - Phone:931-474-7208
Mailing Address - Fax:931-507-7280
Practice Address - Street 1:488 N CHANCERY ST
Practice Address - Street 2:
Practice Address - City:MC MINNVILLE
Practice Address - State:TN
Practice Address - Zip Code:37110-2022
Practice Address - Country:US
Practice Address - Phone:931-474-7208
Practice Address - Fax:931-507-7280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000000664332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4026027OtherBC/BS OF TENNESSEE
TN1454161Medicaid
TN4072930001Medicare ID - Type Unspecified