Provider Demographics
NPI:1871360750
Name:MRS HOMECARE, INC.
Entity type:Organization
Organization Name:MRS HOMECARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO - CPE
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:WALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-265-8450
Mailing Address - Street 1:402B PARK AVE N
Mailing Address - Street 2:
Mailing Address - City:TIFTON
Mailing Address - State:GA
Mailing Address - Zip Code:31794-4320
Mailing Address - Country:US
Mailing Address - Phone:229-520-5709
Mailing Address - Fax:
Practice Address - Street 1:1715 HOWELL MILL RD NW STE C20
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30318-3122
Practice Address - Country:US
Practice Address - Phone:855-361-2727
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MRS HOMECARE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-12-11
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies