Provider Demographics
NPI:1346394897
Name:BRUSHA HOME CARE SERVICES
Entity Type:Organization
Organization Name:BRUSHA HOME CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BEULAH
Authorized Official - Middle Name:J
Authorized Official - Last Name:PATRICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-775-0264
Mailing Address - Street 1:150 WILLIS RD
Mailing Address - Street 2:
Mailing Address - City:FOREST
Mailing Address - State:MS
Mailing Address - Zip Code:39074-9046
Mailing Address - Country:US
Mailing Address - Phone:601-775-0264
Mailing Address - Fax:601-775-0264
Practice Address - Street 1:150 WILLIS RD
Practice Address - Street 2:
Practice Address - City:FOREST
Practice Address - State:MS
Practice Address - Zip Code:39074-9046
Practice Address - Country:US
Practice Address - Phone:601-775-0264
Practice Address - Fax:601-775-0264
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS956343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)