MEDICARE: MEDI-HOME, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility	045	AR

General Provider Information

NPI Number	:	1376562660
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDI-HOME, INC

Provider Business Mailing Address
First Line	:	4623 ROGERS AVE
Second Line	:
City	:	FORT SMITH
State	:	AR
Zip	:	72903-4623
Country	:	US
Telephone Number	:	479-452-1541
Fax Number	:	479-452-2589

Provider Business Practice Location Address
First Line	:	4623 ROGERS AVE
Second Line	:
City	:	FORT SMITH
State	:	AR
Zip	:	72903-4623
Country	:	US
Telephone Number	:	479-452-1541
Fax Number	:	479-452-2589

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. IMELDIA SUE RUSHER
Credential	:	LPN ADM
Telephone Number	:	479-452-1541

Provider Enumeration Date	:	07/18/2006
Last Update Date	:	08/22/2020

Similar Medicare Providers

1356506059 — FSNC INC
Practice Location Address:

4623 ROGERS AVE
FORT SMITH, AR
72903-3148

Practice Phone: 479-452-1541
Practice Fax:

1174079016 — CHAPEL RIDGE NURSING CENTER, LLC
Practice Location Address:

4623 ROGERS AVE
FORT SMITH, AR
72903-3148

Practice Phone: 479-452-1541
Practice Fax:

1609336437 — HANNAH ELIZABETH KING COTA
Practice Location Address:

4623 ROGERS AVE
FORT SMITH, AR
72903-3148

Practice Phone: 479-452-1541
Practice Fax:

1285726356 — DR. KATHY SELLERS SANDERS D.M.D.
Practice Location Address:

4623 FORT HENRY DR
KINGSPORT, TN
37663-2616

Practice Phone: 423-239-7899
Practice Fax: 423-239-0047

1629102231 — LORI LINETTE ANTMAN
Practice Location Address:

4623 FORT CROCKETT BLVD
GALVESTON, TX
77551-5962

Practice Phone: 409-762-7646
Practice Fax:

1932328986 — ISLAND HEALTH CENTER, P.A.
Practice Location Address:

4623 FORT CROCKETT BLVD
GALVESTON, TX
77551-5962

Practice Phone: 409-762-7646
Practice Fax: 409-762-9223

Directions to “MEDI-HOME, INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.