Healthcare Provider Details

I. General information

NPI: 1376570291
Provider Name (Legal Business Name): MID-SOUTH HOME CARE SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2006
Last Update Date: 10/23/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 US HIGHWAY 84 W
OPP AL
36467-3520
US

IV. Provider business mailing address

12900 FOSTER ST STE 400
OVERLAND PARK KS
66213-2649
US

V. Phone/Fax

Practice location:
  • Phone: 334-493-0298
  • Fax:
Mailing address:
  • Phone:
  • 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 SCHWARTZ
Title or Position: DIRECTOR LICENSURE
Credential:
Phone: 913-814-2288