MEDICARE: OXYGEN-MEDICAL EQUIPMENT & SUPPLIES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332BX2000X	Oxygen Equipment & Supplies (DME)	0624146	GA

General Provider Information

NPI Number	:	1275629131
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OXYGEN-MEDICAL EQUIPMENT & SUPPLIES

Provider Business Mailing Address
First Line	:	8596 HIGHWAY 85
Second Line	:
City	:	JONESBORO
State	:	GA
Zip	:	30238-4300
Country	:	US
Telephone Number	:	404-474-7907
Fax Number	:

Provider Business Practice Location Address
First Line	:	8596 HIGHWAY 85
Second Line	:
City	:	JONESBORO
State	:	GA
Zip	:	30238-4300
Country	:	US
Telephone Number	:	404-474-7907
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	EMMANUEL IROANYA
Credential	:
Telephone Number	:	404-474-7907

Provider Enumeration Date	:	10/05/2006
Last Update Date	:	08/22/2020

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