Provider Demographics
NPI:1013069319
Name:HOME OXYGEN & MEDICAL EQUIPMENT, INC.
Entity Type:Organization
Organization Name:HOME OXYGEN & MEDICAL EQUIPMENT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY TREASURER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:W
Authorized Official - Last Name:MILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-924-1729
Mailing Address - Street 1:PO BOX 1395
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MS
Mailing Address - Zip Code:39060-1395
Mailing Address - Country:US
Mailing Address - Phone:601-924-1729
Mailing Address - Fax:601-825-4020
Practice Address - Street 1:136 E NORTHSIDE DR
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MS
Practice Address - Zip Code:39056-3440
Practice Address - Country:US
Practice Address - Phone:601-924-1729
Practice Address - Fax:601-825-4020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2009-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00040676Medicaid
MS0192180001Medicare NSC