1609904283 NPI number — HOME CARE SOLUTIONS, INC.

Table of content: (NPI 1609904283)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609904283 NPI number — HOME CARE SOLUTIONS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOME CARE SOLUTIONS, INC.
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:
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:
1609904283
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1931 VETERANS DR
Provider Second Line Business Mailing Address:
SUITE 201
Provider Business Mailing Address City Name:
SOUTHAVEN
Provider Business Mailing Address State Name:
MS
Provider Business Mailing Address Postal Code:
38671-2009
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
662-393-0020
Provider Business Mailing Address Fax Number:
662-393-0180

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1931 VETERANS DR
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
SOUTHAVEN
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
38671-2009
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
662-393-0020
Provider Business Practice Location Address Fax Number:
662-393-0180
Provider Enumeration Date:
03/02/2007

Additional Information

Authorized Official

Authorized Official Last Name:
ROSENBLOOM
Authorized Official First Name:
JUDY
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
662-393-0020

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  L3(27)4M2-017-6480 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 00747 . This is a "DMRS AGENCY NUMBER" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 0445780 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 00770323 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 00770472 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".




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