Organization
OXYGEN PLUS, CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THERESA CISSY MCLEAN RN (CEO)
(615) 416-1510
Entity
Organization
Contact information
Practice address
2150 WILMA RUDOLPH BLVD, SUITE 4, CLARKSVILLE, TN 37040-6675
(931) 552-2690
(931) 552-3394
Mailing address
900 MCARTHUR STREET, MANCHESTER, TN 37355
(931) 728-4010
(931) 728-0089
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
106910
TN
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
00743
TN
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10074830
AMERIGROUP
TN
05
—
1454268
—
TN
01
—
4057101
BCBS
TN
01
—
A3735500
AMERICHOICE
TN
Enumeration date
10/07/2008
Last updated
06/18/2010
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