Provider Demographics
NPI:1598795759
Name:CARE OXYGEN & HOME MEDICAL, LLC
Entity Type:Organization
Organization Name:CARE OXYGEN & HOME MEDICAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RONNIE
Authorized Official - Middle Name:GREGG
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-939-1808
Mailing Address - Street 1:740 HIGHWAY 49 NORTH
Mailing Address - Street 2:SUITE I
Mailing Address - City:FLORA
Mailing Address - State:MS
Mailing Address - Zip Code:39071
Mailing Address - Country:US
Mailing Address - Phone:601-879-0058
Mailing Address - Fax:601-879-0059
Practice Address - Street 1:740 HIGHWAY 49 NORTH
Practice Address - Street 2:SUITE I
Practice Address - City:FLORA
Practice Address - State:MS
Practice Address - Zip Code:39071
Practice Address - Country:US
Practice Address - Phone:601-879-0058
Practice Address - Fax:601-879-0059
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS06906/11.1332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS5686770001Medicare NSC