Healthcare Provider Details

I. General information

NPI: 1831162932
Provider Name (Legal Business Name): OXYCARE PLUS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2006
Last Update Date: 10/27/2020
Certification Date: 10/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 PEGRAM DR
TUPELO MS
38801-6347
US

IV. Provider business mailing address

404 WILKINS WISE RD SUITE 3
COLUMBUS MS
39705-1711
US

V. Phone/Fax

Practice location:
  • Phone: 662-842-5363
  • Fax: 662-842-5366
Mailing address:
  • Phone: 662-329-9095
  • Fax: 662-329-8699

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: BRYAN LOGAN
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 662-329-9095