Organization Name: | SOUTHERN ILLINOIS OXYGEN & MED SUPPLIES |
NPI Number: | 1003035759 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DELLA DARLENE PUGH (OWNER/OPERATOR) |
Mailing Address: | 1107 W 10th St Metropolis |
State: | IL US |
Postal Code: | 629602432 |
Phone Number: | 6185242825 |
Fax Number: | 6185241659 |
NPI Enumeration Date: | 04/24/2007 |
NPI Last Update Date: | 03/24/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |