Provider Demographics
NPI:1629276563
Name:I.V. CARE, INC.
Entity Type:Organization
Organization Name:I.V. CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:H
Authorized Official - Last Name:LOMENICK
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:662-252-2446
Mailing Address - Street 1:530 J M ASH DR
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:38635-3238
Mailing Address - Country:US
Mailing Address - Phone:662-252-2446
Mailing Address - Fax:662-252-4379
Practice Address - Street 1:530 J M ASH DR
Practice Address - Street 2:
Practice Address - City:HOLLY SPRINGS
Practice Address - State:MS
Practice Address - Zip Code:38635-3238
Practice Address - Country:US
Practice Address - Phone:662-252-2446
Practice Address - Fax:662-252-4379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-03
Last Update Date:2011-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS02246 02 6332B00000X
MS02246 02.63336C0003X
MS02246 02.63336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00030246Medicaid
MS00030246Medicaid