1962687574 NPI number — MAYS HOUSECALL HOME HEALTH, INC

Table of content: (NPI 1962687574)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962687574 NPI number — MAYS HOUSECALL HOME HEALTH, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MAYS HOUSECALL HOME HEALTH, 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:
1962687574
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/15/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3310 LAMAR AVE
Provider Second Line Business Mailing Address:
STE. A
Provider Business Mailing Address City Name:
PARIS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75460-5024
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
903-905-4810
Provider Business Mailing Address Fax Number:
903-905-4812

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
13817 CR 3520
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ADA
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
74820-5615
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
580-436-3322
Provider Business Practice Location Address Fax Number:
580-436-9907
Provider Enumeration Date:
01/02/2008

Additional Information

Authorized Official

Authorized Official Last Name:
DRENNEN
Authorized Official First Name:
ERIK
Authorized Official Middle Name:
K.
Authorized Official Title or Position:
CHIEF EXECUTIVE OFFICER
Authorized Official Telephone Number:
580-298-3947

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  7770 , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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