Organization
THE ELMS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TINA COX (ADMINISTRATOR)
(309) 837-5482
Entity
Organization
Contact information
Practice address
1212 MADELYN AVE, MACOMB, IL 61455-3324
(309) 837-5482
(309) 833-1054
Mailing address
1212 MADELYN AVE, MACOMB, IL 61455-3324
(309) 837-5482
(309) 833-1054
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
0021568
IL
Other
Enumeration date
09/29/2016
Last updated
09/29/2016
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