Provider Demographics
NPI:1124279807
Name:OXYGEN PLUS, CORP
Entity type:Organization
Organization Name:OXYGEN PLUS, CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:CISSY
Authorized Official - Last Name:MCLEAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:615-891-4154
Mailing Address - Street 1:900 MCARTHUR ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:TN
Mailing Address - Zip Code:37355-2326
Mailing Address - Country:US
Mailing Address - Phone:931-728-4010
Mailing Address - Fax:931-728-0089
Practice Address - Street 1:300 N LIMESTONE ST
Practice Address - Street 2:
Practice Address - City:GAFFNEY
Practice Address - State:SC
Practice Address - Zip Code:29340-3138
Practice Address - Country:US
Practice Address - Phone:864-489-8835
Practice Address - Fax:864-489-8864
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-01
Last Update Date:2012-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6510133332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCDE3198Medicaid
SCDE3198Medicaid