1457502452 NPI number — MID-SOUTH HOME HEALTH, LLC

Table of content: (NPI 1477694594)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457502452 NPI number — MID-SOUTH HOME HEALTH, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MID-SOUTH HOME HEALTH, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1457502452
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/13/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1509
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LOUISVILLE
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40201-1509
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
913-814-2716
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2800 DAUPHIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MOBILE
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
36606-2477
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
251-316-0917
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/08/2008

Additional Information

Authorized Official

Authorized Official Last Name:
TURNER
Authorized Official First Name:
SEAN
Authorized Official Middle Name:
PATRICK
Authorized Official Title or Position:
VP REVENUE CYCLE
Authorized Official Telephone Number:
810-360-3133

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , registered in the state of NULL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 115209 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".




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