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General NPI Number Information
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NPI Number | 1043213358
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Entity Type | Organization
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Legal Business Name | MRS HOMECARE, INC.
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Dates
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Enumeration Date | 05/31/2005
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Last Update Date | 05/08/2012
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Provider Practice Location Address
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Address Line | 2467A S MAIN ST
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City | MOULTRIE
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State | GA
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Zip | 31768-6531
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Country | US
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Telephone | 229-890-6949
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Fax | 229-890-7386
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Provider Business Mailing Address
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Address Line | PO BOX 568
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City | ALBANY
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State | GA
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Zip | 31702-0568
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Country | US
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Telephone | 229-439-2403
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Fax | 229-883-8426
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. E. THOMAS RIDDLE
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Credential |
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Telephone | 229-439-2403
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number |
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License Number State |
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