Provider Demographics
NPI:1609936160
Name:TOS HOME HEALTH CARE INC
Entity Type:Organization
Organization Name:TOS HOME HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TYLER
Authorized Official - Middle Name:V
Authorized Official - Last Name:BERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-785-4300
Mailing Address - Street 1:1125 HERSCHEL BESS BLVD
Mailing Address - Street 2:
Mailing Address - City:POPLAR BLUFF
Mailing Address - State:MO
Mailing Address - Zip Code:63901-3071
Mailing Address - Country:US
Mailing Address - Phone:573-785-4300
Mailing Address - Fax:573-785-7991
Practice Address - Street 1:1125 HERSCHEL BESS BLVD
Practice Address - Street 2:
Practice Address - City:POPLAR BLUFF
Practice Address - State:MO
Practice Address - Zip Code:63901-3071
Practice Address - Country:US
Practice Address - Phone:573-785-4300
Practice Address - Fax:573-785-7991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO622036408Medicaid
MO852036409Medicaid
MO852036409Medicaid