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NPI Code Detail

MEDICARE: MID-SOUTH HOME HEALTH, LLC

MEDICARE: MID-SOUTH HOME HEALTH, LLC
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
1372500000XChore ProviderI000000015373TN
2372600000XAdult CompanionI000000015373TN
33747P1801XPersonal Care AttendantI000000015373TN
4376J00000XHomemakerI000000015373TN
5376K00000XNurse's AideI000000015373TN
6374U00000XHome Health AideI000000015373TN

General Provider Information

NPI Number : 1801292081
Entity Type Code : Organization
Provider Name (Legal Business Name) : MID-SOUTH HOME HEALTH, LLC
Provider Business Mailing Address
First Line : 5050 POPLAR AVE
Second Line : SUITE #2404
City : MEMPHIS
State : TN
Zip : 38157-0101
Country : US
Telephone Number : 901-313-0217
Fax Number :
Provider Business Practice Location Address
First Line : 5050 POPLAR AVE
Second Line : SUITE #2404
City : MEMPHIS
State : TN
Zip : 38157-0101
Country : US
Telephone Number : 901-313-0217
Fax Number :
Authorized Official
Title or Position : OWNER/DIRECTOR
Name : MR. JOHN MARK HOSKINS
Credential :
Telephone Number : 901-605-9607
Provider Enumeration Date : 11/14/2014
Last Update Date : 11/14/2014

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Directions to “MID-SOUTH HOME HEALTH, LLC ” Practice Location

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