Provider Demographics
NPI:1962690867
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:
Authorized Official - Phone:615-320-1011
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:615-896-7787
Mailing Address - Fax:615-896-7783
Practice Address - Street 1:814 S CHURCH ST
Practice Address - Street 2:SUITE 113
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37130-4991
Practice Address - Country:US
Practice Address - Phone:615-896-7787
Practice Address - Fax:615-896-7783
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OXYGEN PLUS, CORP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-10-05
Last Update Date:2010-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN106910332BC3200X
TN00743332BP3500X
TN0000001961332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4057101OtherBCBS
TN1454268Medicaid
TN10074830OtherAMERIGROUP
TNA3735500OtherAMERICHOICE
TN4057101OtherBCBS