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General NPI Number Information
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NPI Number | 1063593804
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Entity Type | Organization
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Legal Business Name | QUALITY HOME OXYGEN, INC.
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Dates
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Enumeration Date | 10/18/2006
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Last Update Date | 08/10/2011
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Provider Practice Location Address
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Address Line | 228 STATE ST
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City | MCCOMB
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State | MS
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Zip | 39648-3939
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Country | US
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Telephone | 601-684-9386
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Fax | 601-684-1055
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Provider Business Mailing Address
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Address Line | 145 W HICKORY ST
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City | PONCHATOULA
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State | LA
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Zip | 70454-3215
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Country | US
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Telephone | 985-386-4760
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Fax | 985-386-4761
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ROBERT M FISHER
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Credential |
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Telephone | 601-684-8923
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 02453-11.1
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License Number State | MS
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