Provider Demographics
NPI:1285962076
Name:KARE-IN-HOME MEDICAL EQUIPMENT LLC
Entity type:Organization
Organization Name:KARE-IN-HOME MEDICAL EQUIPMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:CLAYTON
Authorized Official - Last Name:BLALACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:228-604-2155
Mailing Address - Street 1:10278 CORPORATE DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39503-4604
Mailing Address - Country:US
Mailing Address - Phone:228-896-7660
Mailing Address - Fax:228-896-7680
Practice Address - Street 1:10278 CORPORATE DR
Practice Address - Street 2:SUITE A
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39503-4604
Practice Address - Country:US
Practice Address - Phone:228-896-7660
Practice Address - Fax:228-896-7680
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-07
Last Update Date:2018-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS08614/11.1332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS6440620001Medicare NSC