Provider Demographics
NPI:1285747741
Name:PREFERRED HOME CARE, INC.
Entity type:Organization
Organization Name:PREFERRED HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PURCHASING AGENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:KELLY
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-534-4774
Mailing Address - Street 1:PO BOX 867
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:MS
Mailing Address - Zip Code:38652-0867
Mailing Address - Country:US
Mailing Address - Phone:662-534-4774
Mailing Address - Fax:
Practice Address - Street 1:494 W BANKHEAD ST
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:MS
Practice Address - Zip Code:38652-3319
Practice Address - Country:US
Practice Address - Phone:662-534-4774
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-17
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS03811/11.1332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00440015Medicaid
MS00440015Medicaid
MS0233920001Medicare ID - Type UnspecifiedPROVIDER NUMBER