MEDICARE: MRS HOMECARE, INC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332BX2000X	Oxygen Equipment & Supplies (DME)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1477556777
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MRS HOMECARE, INC.

Provider Business Mailing Address
First Line	:	PO BOX 568
Second Line	:
City	:	ALBANY
State	:	GA
Zip	:	31702-0568
Country	:	US
Telephone Number	:	229-439-2403
Fax Number	:	229-883-8426

Provider Business Practice Location Address
First Line	:	1497 KENNEDY RD
Second Line	:
City	:	TIFTON
State	:	GA
Zip	:	31794-4159
Country	:	US
Telephone Number	:	229-382-2002
Fax Number	:	229-388-1966

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. E THOMAS RIDDLE
Credential	:
Telephone Number	:	229-439-2403

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	05/02/2012

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Directions to “MRS HOMECARE, INC. ” Practice Location

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