Organization
SOUTHERN ILLINOIS OXYGEN, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DELLA DARLENE PUGH R.N. (PRESIDENT)
(618) 285-6370
Entity
Organization
Contact information
Practice address
RR 146, ROSICLARE, IL 62982
(618) 285-3511
(618) 285-3597
Mailing address
PO BOX 382, ELIZABETHTOWN, IL 62931-0382
(618) 285-3511
(618) 285-3597
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
332B00000X
PROVIDER TAXONOMY NUMBER
IL
Enumeration date
08/06/2007
Last updated
03/14/2008
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