NPIMap

Organization Active NPI

Palmetto Oxygen, LLC

  • Oxygen Equipment & Supplies (DME)
  • Jackson, MS
National Provider Identifier
1295770824
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X
License
06960/11.1 Issued in MS
Legal business name
PALMETTO OXYGEN, LLC
Practice address
409 Briarwood Dr
Suite 305B
Jackson, MS 39206-3033
Phone
(601) 957-9272
Fax
(601) 957-9545
NPI assigned
Jun 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Matthew S. Mellott
Title
Cfo
Phone
(864) 527-5970

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oxygen Equipment & Supplies (DME) 332BX2000X 06960/11.1 MS Primary

Addresses

Primary practice location

409 Briarwood Dr
Suite 305B
Jackson, MS 39206-3033

Mailing address

110 W North St
Suite 100
Greenville, SC 29601-2779
Phone (864) 527-5970

Other names 1

  • MedBridge Home Medical Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Palmetto Oxygen LLC9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

409 Briarwood Dr
Ste 305B
Jackson, MS 39206
Phone (601) 957-9272

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1295770824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 W NORTH ST",
            "address_2": "SUITE 100",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012779",
            "telephone_number": "864-527-5970",
            "fax_number": "864-527-5971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 BRIARWOOD DR",
            "address_2": "SUITE 305B",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392063033",
            "telephone_number": "601-957-9272",
            "fax_number": "601-957-9545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMETTO OXYGEN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MELLOTT",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "864-527-5970",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "MS",
            "license": "06960/11.1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MedBridge Home Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jackson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.