Healthcare Provider Details

I. General information

NPI: 1053474684
Provider Name (Legal Business Name): HOME OXYGEN AND MEDICAL EQUIPMENT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

708 E NORTHSIDE DR
CLINTON MS
39056-3438
US

IV. Provider business mailing address

708 E NORTHSIDE DR
CLINTON MS
39056-3438
US

V. Phone/Fax

Practice location:
  • Phone: 601-925-8005
  • Fax: 601-924-9127
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number02164026
License Number StateMS

VIII. Authorized Official

Name: WESLEY MILEY
Title or Position: CORP PRES
Credential: RPH
Phone: 601-924-8935