Provider Demographics
NPI:1336855360
Name:PATRICIA AT YOUR SERVICE., LLC
Entity Type:Organization
Organization Name:PATRICIA AT YOUR SERVICE., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HURTH
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:901-238-9558
Mailing Address - Street 1:PO BOX 1204
Mailing Address - Street 2:
Mailing Address - City:SOUTHAVEN
Mailing Address - State:MS
Mailing Address - Zip Code:38671-0112
Mailing Address - Country:US
Mailing Address - Phone:901-238-9558
Mailing Address - Fax:
Practice Address - Street 1:3215 TINA RENEE LN
Practice Address - Street 2:
Practice Address - City:NESBIT
Practice Address - State:MS
Practice Address - Zip Code:38651-2510
Practice Address - Country:US
Practice Address - Phone:901-238-9558
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-24
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care