Organization
SOUTHEASTERN HOME OXYGEN SERVICE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEREMY KILLOUGH (PRESIDENT)
(706) 327-8993
Entity
Organization
Contact information
Practice address
2310 CRAWFORD RD STE 106, PHENIX CITY, AL 36867-3612
(334) 384-9244
(334) 384-9246
Mailing address
PO BOX 4358, COLUMBUS, GA 31914-0358
(706) 327-8993
(706) 327-0254
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
467
AL
Other
Enumeration date
12/23/2015
Last updated
12/23/2015
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