Provider Demographics
NPI:1760939904
Name:EP'S ON THE GO
Entity Type:Organization
Organization Name:EP'S ON THE GO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXERCISE PHYSIOLOGIST/CEO
Authorized Official - Prefix:
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:CCRP
Authorized Official - Phone:601-456-9894
Mailing Address - Street 1:5773 OLD CANTON RD
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39211-3202
Mailing Address - Country:US
Mailing Address - Phone:601-456-9894
Mailing Address - Fax:
Practice Address - Street 1:5773 OLD CANTON RD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39211-3202
Practice Address - Country:US
Practice Address - Phone:601-456-9894
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-06
Last Update Date:2016-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251B00000XAgenciesCase Management
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care