Healthcare Provider Details

I. General information

NPI: 1598741266
Provider Name (Legal Business Name): BAPTIST HOME MEDICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2005
Last Update Date: 05/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

822 FOLEY ST
JACKSON MS
39202-3404
US

IV. Provider business mailing address

406 MEDICAL CENTER DR
JASPER AL
35501-3400
US

V. Phone/Fax

Practice location:
  • Phone: 601-968-9700
  • Fax: 601-968-9702
Mailing address:
  • Phone: 205-221-8200
  • Fax: 205-221-8270

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number04419/11.1
License Number StateMS
# 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 Number04419/11.1
License Number StateMS

VIII. Authorized Official

Name: MR. STEWART H PACE
Title or Position: PRESIDENT, BOARD OF MANAGERS
Credential:
Phone: 205-414-7525