Provider Demographics
NPI:1407740277
Name:AMPLE HEART HOMECARE SERVICES
Entity type:Organization
Organization Name:AMPLE HEART HOMECARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:SALLYE
Authorized Official - Middle Name:
Authorized Official - Last Name:FARMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-715-9623
Mailing Address - Street 1:928 GOODMAN RD E STE 202
Mailing Address - Street 2:
Mailing Address - City:SOUTHAVEN
Mailing Address - State:MS
Mailing Address - Zip Code:38671-8824
Mailing Address - Country:US
Mailing Address - Phone:662-715-9623
Mailing Address - Fax:662-228-4370
Practice Address - Street 1:928 GOODMAN RD E STE 202
Practice Address - Street 2:
Practice Address - City:SOUTHAVEN
Practice Address - State:MS
Practice Address - Zip Code:38671-8824
Practice Address - Country:US
Practice Address - Phone:662-715-9623
Practice Address - Fax:662-228-4370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-05
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No385H00000XRespite Care FacilityRespite Care