Provider Demographics
NPI:1598363160
Name:MOBILE IN HOME CARE
Entity Type:Organization
Organization Name:MOBILE IN HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-408-8556
Mailing Address - Street 1:3929 AIRPORT BLVD # 1
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36609-1987
Mailing Address - Country:US
Mailing Address - Phone:251-202-4860
Mailing Address - Fax:
Practice Address - Street 1:3929 AIRPORT BLVD # 1
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36609-1987
Practice Address - Country:US
Practice Address - Phone:251-202-4860
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-15
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care