Healthcare Provider Details

I. General information

NPI: 1952566259
Provider Name (Legal Business Name): RELIABLE OXYGEN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2008
Last Update Date: 07/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 S RAILROAD AVE
BROOKHAVEN MS
39601-3330
US

IV. Provider business mailing address

PO BOX 1493
MONTICELLO MS
39654-1493
US

V. Phone/Fax

Practice location:
  • Phone: 601-833-1040
  • Fax: 601-833-1045
Mailing address:
  • Phone: 601-587-0422
  • Fax: 601-587-0423

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MR. MICHAEL C CAMPBELL
Title or Position: OWNER
Credential:
Phone: 601-833-1040