Healthcare Provider Details

I. General information

NPI: 1437286010
Provider Name (Legal Business Name): HOME OXYGEN AND MEDICAL EQUIPMENT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2007
Last Update Date: 10/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

136 E NORTHSIDE DR
CLINTON MS
39056-3440
US

IV. Provider business mailing address

PO BOX 1395
CLINTON MS
39060-1395
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number02164/2.6
License Number StateMS

VIII. Authorized Official

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