Provider Demographics
NPI:1407361371
Name:MID-SOUTH HOME CARE SERVICES, LLC
Entity Type:Organization
Organization Name:MID-SOUTH HOME CARE SERVICES, LLC
Other - Org Name:KINDRED PALLIATIVE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF LICESURE
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:COMBS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-814-2013
Mailing Address - Street 1:PO BOX 4060
Mailing Address - Street 2:ATTN: REGULATORY
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-4060
Mailing Address - Country:US
Mailing Address - Phone:704-664-2876
Mailing Address - Fax:
Practice Address - Street 1:2800 DAUPHIN ST STE 103
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36606-2400
Practice Address - Country:US
Practice Address - Phone:251-478-9900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-13
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative MedicineGroup - Single Specialty