Healthcare Provider Details

I. General information

NPI: 1154304491
Provider Name (Legal Business Name): HOME HEALTH CARE SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2005
Last Update Date: 01/11/2024
Certification Date: 01/11/2024
Deactivation Date: 07/17/2007
Reactivation Date: 07/25/2007

III. Provider practice location address

115 S MARTIN LUTHER KING JR DR
INDIANOLA MS
38751-2698
US

IV. Provider business mailing address

805 N WHITTINGTON PKWY
LOUISVILLE KY
40222-7101
US

V. Phone/Fax

Practice location:
  • Phone: 662-887-1202
  • Fax: 662-887-3170
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateMS

VIII. Authorized Official

Name: MARGARET S PEMBERTON
Title or Position: VICE PRESIDENT
Credential:
Phone: 502-394-2321