Provider Demographics
NPI:1033434139
Name:MRS HOMECARE, INC.
Entity Type:Organization
Organization Name:MRS HOMECARE, INC.
Other - Org Name:MRS OF BAINBRIDGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:MS
Authorized Official - First Name:DELORES
Authorized Official - Middle Name:ANITA
Authorized Official - Last Name:CANON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-439-2403
Mailing Address - Street 1:711 N JEFFERSON ST
Mailing Address - Street 2:P.O. BOX 568
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31701-5120
Mailing Address - Country:US
Mailing Address - Phone:229-439-2403
Mailing Address - Fax:229-883-8426
Practice Address - Street 1:1509 E SHOTWELL ST
Practice Address - Street 2:SUITE C
Practice Address - City:BAINBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:39819-4201
Practice Address - Country:US
Practice Address - Phone:229-493-0071
Practice Address - Fax:229-493-0073
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-31
Last Update Date:2010-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA0361890016Medicare NSC