Healthcare Provider Details

I. General information

NPI: 1851323703
Provider Name (Legal Business Name): HOME HEALTH NETWORK SPECIALISTS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 08/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

808 HUNTER SUITE 3
SIKESTON MO
63801
US

IV. Provider business mailing address

PO BOX 1210
SIKESTON MO
63801-1210
US

V. Phone/Fax

Practice location:
  • Phone: 573-472-4165
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number00010727
License Number StateMO

VIII. Authorized Official

Name: CLIFTON SHIRRELL
Title or Position: CORPORATE SECRETARY
Credential:
Phone: 573-471-1276