Healthcare Provider Details

I. General information

NPI: 1487624334
Provider Name (Legal Business Name): HEALTHCARE SERVICES OF MISSISSIPPI INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2006
Last Update Date: 07/31/2025
Certification Date: 07/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

934 BROADWAY DR STE 60
HATTIESBURG MS
39401-7516
US

IV. Provider business mailing address

PO BOX 27968
SALT LAKE CITY UT
84127-0968
US

V. Phone/Fax

Practice location:
  • Phone: 601-545-3007
  • Fax: 601-545-3062
Mailing address:
  • Phone: 407-246-1226
  • Fax: 407-648-2297

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 Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: MRS. ROBIN L MENCHEN
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 407-822-4600