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General NPI Number Information
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NPI Number | 1891983672
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Entity Type | Organization
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Legal Business Name | OXYGEN PLUS, CORP
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Dates
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Enumeration Date | 10/05/2007
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Last Update Date | 01/21/2009
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Provider Practice Location Address
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Address Line | 307 BETSY PACK DR
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City | JASPER
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State | TN
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Zip | 37347-3317
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Country | US
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Telephone | 423-742-0711
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Fax |
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Provider Business Mailing Address
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Address Line | 307 BETSY PACK DR
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City | JASPER
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State | TN
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Zip | 37347-3317
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Country | US
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Telephone | 423-742-0711
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | THERESA C MCLEAN
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Credential |
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Telephone | 615-320-1011
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336M0002X
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Taxonomy Name | Mail Order Pharmacy
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License Number | 3868
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number | 0000001961
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License Number State | TN
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