MEDICARE: MID-SOUTH HOME CARE SERVICES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)
2	332BX2000X	Oxygen Equipment & Supplies (DME)
3	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1215967344
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MID-SOUTH HOME CARE SERVICES, INC.

Provider Business Mailing Address
First Line	:	12900 FOSTER ST
Second Line	:	SUITE 400
City	:	OVERLAND PARK
State	:	KS
Zip	:	66213-2649
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	802 CCS ST
Second Line	:
City	:	FORT WALTON BEACH
State	:	FL
Zip	:	32547-3699
Country	:	US
Telephone Number	:	913-814-2800
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR LICENSURE
Name	:	RUTH SCHWARTZ
Credential	:
Telephone Number	:	913-814-2288

Provider Enumeration Date	:	07/04/2006
Last Update Date	:	04/18/2008

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