MEDICARE: THE OXFORD CENTRE, INC.

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	324500000X	Substance Abuse Rehabilitation Facility

General Provider Information

NPI Number	:	1922377563
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE OXFORD CENTRE, INC.

Provider Business Mailing Address
First Line	:	PO BOX 3488
Second Line	:	DEPT. 05-020
City	:	TUPELO
State	:	MS
Zip	:	38803-3488
Country	:	US
Telephone Number	:	662-281-9992
Fax Number	:	662-281-1326

Provider Business Practice Location Address
First Line	:	297 COUNTY ROAD 244
Second Line	:
City	:	ETTA
State	:	MS
Zip	:	38627-9523
Country	:	US
Telephone Number	:	662-281-9992
Fax Number	:	662-281-1326

Authorized Official
Title or Position	:	SECRETARY/TREAS
Name	:	THOMAS FOWLKES
Credential	:	MD
Telephone Number	:	662-281-9992

Provider Enumeration Date	:	12/28/2011
Last Update Date	:	03/05/2014

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