Healthcare Provider Details

I. General information

NPI: 1255173068
Provider Name (Legal Business Name): SRX HOME CARE LLC, DBA HAPPIER AT HOME
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2024
Last Update Date: 09/16/2024
Certification Date: 09/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

246 S MAIN ST STE B
FAYETTE IA
52142-7652
US

IV. Provider business mailing address

PO BOX 188
FAYETTE IA
52142-0188
US

V. Phone/Fax

Practice location:
  • Phone: 563-412-9918
  • Fax:
Mailing address:
  • Phone: 563-412-9918
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: MRS. ANDREA M SCOTT
Title or Position: OWNER
Credential: CPHT
Phone: 319-461-5396