Healthcare Provider Details

I. General information

NPI: 1285865840
Provider Name (Legal Business Name): MID-SOUTH HOME CARE SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2009
Last Update Date: 07/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1328 GREENBRIER RD SUITE A & B
ANNISTON AL
36207-6702
US

IV. Provider business mailing address

12900 FOSTER ST SUITE 400
OVERLAND PARK KS
66213-2704
US

V. Phone/Fax

Practice location:
  • Phone: 256-835-5838
  • Fax: 256-835-6173
Mailing address:
  • Phone: 913-814-2800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: RUTH C SCHWARTZ
Title or Position: ASSISTANT SECRETARY
Credential:
Phone: 913-814-2288