Healthcare Provider Details

I. General information

NPI: 1114075595
Provider Name (Legal Business Name): HOME OXYGEN & MEDICAL EQUIPMENT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

134 E NORTHSIDE DR
CLINTON MS
39056-3659
US

IV. Provider business mailing address

PO BOX 1395
CLINTON MS
39060-1395
US

V. Phone/Fax

Practice location:
  • Phone: 601-924-8935
  • Fax: 601-924-9127
Mailing address:
  • Phone: 601-924-8935
  • Fax: 601-924-9127

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number02413 01.1
License Number StateMS

VIII. Authorized Official

Name: MR. WESLEY A MILEY
Title or Position: OWNER
Credential: RPH
Phone: 601-924-8935