=====================================================
General NPI Number Information
=====================================================
NPI Number | 1689892184
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | VMS HOME OXYGEN
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/23/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1826 OWEN DR
-----------------------------------------------------
City | FAYETTEVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28304-3421
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 910-483-9286
-----------------------------------------------------
Fax | 910-892-1767
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 107 DUBOIS CIR
-----------------------------------------------------
City | DUNN
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28334-3538
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 910-892-9286
-----------------------------------------------------
Fax | 910-892-1767
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CHEIF OPERATING OFFICER
-----------------------------------------------------
Name | MR. LEWIS BELL
-----------------------------------------------------
Credential | RT
-----------------------------------------------------
Telephone | 910-892-9286
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number | 01286
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------