Provider Demographics
NPI:1063105948
Name:OXCOM HOME CARE PROFESSIONALS LLC.
Entity type:Organization
Organization Name:OXCOM HOME CARE PROFESSIONALS LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REPRESENTATIVE
Authorized Official - Prefix:MR
Authorized Official - First Name:KEATON
Authorized Official - Middle Name:
Authorized Official - Last Name:OXENDINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-785-4016
Mailing Address - Street 1:PO BOX 1156
Mailing Address - Street 2:
Mailing Address - City:DILLON
Mailing Address - State:SC
Mailing Address - Zip Code:29536-1156
Mailing Address - Country:US
Mailing Address - Phone:910-734-3818
Mailing Address - Fax:
Practice Address - Street 1:226 E MAIN ST
Practice Address - Street 2:
Practice Address - City:DILLON
Practice Address - State:SC
Practice Address - Zip Code:29536-3440
Practice Address - Country:US
Practice Address - Phone:910-785-4016
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-29
Last Update Date:2023-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care