Provider Demographics
NPI:1659878676
Name:PROFESSIONAL HEALTH CARE SERVICES INC
Entity Type:Organization
Organization Name:PROFESSIONAL HEALTH CARE SERVICES INC
Other - Org Name:PHCS HOME MEDICAL EQUIPMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TIM
Authorized Official - Middle Name:
Authorized Official - Last Name:MIXON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-947-5593
Mailing Address - Street 1:14965 STATE HIGHWAY 59 STE 102
Mailing Address - Street 2:
Mailing Address - City:FOLEY
Mailing Address - State:AL
Mailing Address - Zip Code:36535-2471
Mailing Address - Country:US
Mailing Address - Phone:251-947-5593
Mailing Address - Fax:
Practice Address - Street 1:2407 JENKS AVE
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405-4308
Practice Address - Country:US
Practice Address - Phone:877-978-4038
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PROFESSIONAL HEALTH CARE SERVICES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-04-06
Last Update Date:2018-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies