Provider Demographics
NPI:1609172659
Name:OXY-CARE HOME MEDICAL EQUIPMENT, LLC
Entity Type:Organization
Organization Name:OXY-CARE HOME MEDICAL EQUIPMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/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 1:1344 TUSCULUM BLVD
Mailing Address - Street 2:
Mailing Address - City:GREENEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37745-4218
Mailing Address - Country:US
Mailing Address - Phone:423-798-8021
Mailing Address - Fax:423-798-8023
Practice Address - Street 1:1344 TUSCULUM BLVD
Practice Address - Street 2:
Practice Address - City:GREENEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37745-4218
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:2011-02-08
Last Update Date:2016-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000000910332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0000000910OtherTN DEPARTMENT OF HEALTHCARE FACILITIES
TN1523842Medicaid
TN0000000910OtherTN DEPARTMENT OF HEALTHCARE FACILITIES