Healthcare Provider Details
I. General information
NPI: 1083916589
Provider Name (Legal Business Name): RUSH HOME CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/03/2010
Last Update Date: 12/21/2022
Certification Date: 12/21/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1730A 14TH ST
MERIDIAN MS
39301-4140
US
IV. Provider business mailing address
PO BOX 908
MERIDIAN MS
39302-0908
US
V. Phone/Fax
- Phone: 601-703-4395
- Fax: 601-703-4394
- Phone: 601-213-3010
- Fax: 601-213-3011
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085U0001X |
| Taxonomy | Diagnostic Ultrasound Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DON
LARKIN
KENNEDY
Title or Position: REGIONAL CEO
Credential:
Phone: 601-703-9614