Provider Demographics
NPI:1154394476
Name:OXYCARE PLUS, INC.
Entity type:Organization
Organization Name:OXYCARE PLUS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LOGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-329-9095
Mailing Address - Street 1:404 WILKINS WISE RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:COLUMBUS
Mailing Address - State:MS
Mailing Address - Zip Code:39705-1711
Mailing Address - Country:US
Mailing Address - Phone:662-329-9095
Mailing Address - Fax:662-329-8699
Practice Address - Street 1:404 WILKINS WISE RD
Practice Address - Street 2:SUITE 3
Practice Address - City:COLUMBUS
Practice Address - State:MS
Practice Address - Zip Code:39705-1711
Practice Address - Country:US
Practice Address - Phone:662-329-9095
Practice Address - Fax:662-329-8699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-08
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00440836Medicaid
MS04965/11.1OtherBOARD OF PHARMACY
AL622OtherAL BOARD OF HME SUPPLIERS
AL009985220Medicaid
AL900407OtherBOARD OF PHARMACY
AL900407OtherBOARD OF PHARMACY