Provider Demographics
NPI:1588635866
Name:MAYS HOUSECALL HOME HEALTH, INC.
Entity Type:Organization
Organization Name:MAYS HOUSECALL HOME HEALTH, INC.
Other - Org Name:PROFESSIONAL HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIK
Authorized Official - Middle Name:K
Authorized Official - Last Name:DRENNEN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:580-298-3947
Mailing Address - Street 1:3310 LAMAR AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:PARIS
Mailing Address - State:TX
Mailing Address - Zip Code:75460-5024
Mailing Address - Country:US
Mailing Address - Phone:903-905-4810
Mailing Address - Fax:903-905-4812
Practice Address - Street 1:507 E REDWOOD
Practice Address - Street 2:
Practice Address - City:SALLISAW
Practice Address - State:OK
Practice Address - Zip Code:74955-3020
Practice Address - Country:US
Practice Address - Phone:918-776-9400
Practice Address - Fax:918-776-9200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-27
Last Update Date:2015-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK7564251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100260240 AMedicaid
OK100260240 BMedicaid
OK100260240 BMedicaid