SOUTHERN HOME HEALTHCARE INC (NPI# 1790787042) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1790787042 |
Entity Type | Organization |
Organization Name | SOUTHERN HOME HEALTHCARE INC |
Practice Address |
2925 S Caraway Rd Ste B Jonesboro AR 72401 |
Mailing Address |
2925 South Caraway Road Jonesboro AR 72401-7313 |
Practice Telephone | 8709320990 |
Practice Fax Number | 8709321124 |
Mailing Telephone | 8709320990 |
Mailing Fax Number | 8709321124 |
Enumeration Date | 2005-06-01 |
Last Update Date | 2018-08-21 |
Authorized Official Name | STEVE TRICARICO (OWNER / MANAGER) |
Authorized Official Telephone | 8709320990 |
Is Organization Subpart | Y |
Parent Organization Name | SOUTHERN HOME HEALTHCARE INC |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 332BX2000X |
Durable Medical Equipment & Medical Supplies Specialization: Oxygen Equipment & Supplies |
Suppliers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
AR | BCBS ORTHOTIC PROVIDER | 49852 | 01 |
AR | 150051716 | 05 | |
AR | BCBS DME PROVIDER | 49854 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1386124022 | Southern Home Healthcare Inc | Durable Medical Equipment & Medical Supplies | 1058 Highland Cir Ste 12, Mountain Home, AR 72653-3275 | 2018-08-21 |
Street Address |
2925 S CARAWAY RD STE B |
City | JONESBORO |
State | AR |
Zip Code | 72401 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1407453368 | Mariah Kay Jackson | Physical Therapy Assistant | Creative Kids Therapy, Jonesboro, AR 72401 | 2020-10-05 |
1821606005 | Kafayat Folake Iyanda | Specialist/Technologist | 2105 East Aggie Rd, Jonesboro, AR 72401 | 2020-07-14 |
1053936310 | Josh Roberts | Physical Therapist | 1010 South Main St, Jonesboro, AR 72401 | 2020-06-12 |
1003449687 | Amy Mary Elizabeth Daughhetee | Nurse Practitioner | 225 East Washington Ave, Jonesboro, AR 72401 | 2020-02-21 |
1871126698 | Sarah Lowtharp | Clinical Nurse Specialist | 225 East Washington Ave., Jonesboro, AR 72401 | 2020-02-20 |
1891335519 | Mallori Miller | Case Manager/Care Coordinator | 837 Willett Rd, Jonesboro, AR 72401 | 2020-01-10 |
1265073704 | Michael Bruce Collie | Registered Nurse | 837 Williett Road, Jonesboro, AR 72401 | 2019-10-07 |
1285283432 | Jonesboro Ambulatory Surgery Center, LLC | Clinic/Center | 1710 Mayfield Dr, Jonesboro, AR 72401 | 2019-09-10 |
1841843943 | Destinee Katrina Cole | Specialist/Technologist | 2015 Aggie Rd, Jonesboro, AR 72401 | 2019-07-18 |
1699250472 | Jessica Marie Mcnatt | Occupational Therapist | 907 County Road 753, Jonesboro, AR 72401 | 2018-09-27 |
Find all providers in zip 72401 |
Taxonomy Code | 332BX2000X |
Grouping | Suppliers |
Classification | Durable Medical Equipment & Medical Supplies |
Specialization | Oxygen Equipment & Supplies |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1679041263 | Elite Medical Care, LLC | Durable Medical Equipment & Medical Supplies | 4924 E Nettleton Ave, Jonesboro, AR 72401-6553 | 2018-11-13 |
1568991214 | Rehab Medical, Inc | Durable Medical Equipment & Medical Supplies | 8568 Highway 85, Jonesboro, GA 30238 | 2017-06-07 |
1124409065 | Claude Sims | Durable Medical Equipment & Medical Supplies | 918 Brandon Hill Way, Jonesboro, GA 30238-4483 | 2015-06-16 |
1033487491 | Affordable Home Health Care Inc | Durable Medical Equipment & Medical Supplies | 4707 E Johnson Ave, Jonesboro, AR 72401-1999 | 2011-12-13 |
1356410864 | Medical Solutions of Arkansas, LLC | Durable Medical Equipment & Medical Supplies | 1000 E Matthews Ave Ste F, Jonesboro, AR 72401-4344 | 2006-11-07 |
1275629131 | Oxygen-medical Equipment & Supplies | Durable Medical Equipment & Medical Supplies | 8596 Highway 85, Jonesboro, GA 30238-4300 | 2006-10-05 |
1912900945 | Scientech Medical Supplies, Inc. | Durable Medical Equipment & Medical Supplies | 7000 Tara Blvd, Suite F, Jonesboro, GA 30236-1600 | 2005-05-23 |
1902021462 | C & J Medical Supplies | Durable Medical Equipment & Medical Supplies | 299 N Main St, Jonesboro, GA 30236-3234 | 2007-04-17 |
1376633008 | Pro-med of Jonesboro Inc | Durable Medical Equipment & Medical Supplies | 300 Carson St, Suite 103, Jonesboro, AR 72401-3104 | 2006-10-13 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1689281222 | Unified Medical Equipment Solutions | Durable Medical Equipment & Medical Supplies | 2000 Mclain St Ste F, Newport, AR 72112-3762 | 2020-09-28 |
1639639040 | Adapthealth - Missouri LLC | Durable Medical Equipment & Medical Supplies | 5436 Bleaux Ave Ste A, Springdale, AR 72762-0750 | 2019-03-21 |
1386124022 | Southern Home Healthcare Inc | Durable Medical Equipment & Medical Supplies | 1058 Highland Cir Ste 12, Mountain Home, AR 72653-3275 | 2018-08-21 |
1568820330 | Sleep Partners, LLC | Durable Medical Equipment & Medical Supplies | 5 Medical Ln, Suite C & D, Conway, AR 72034-4912 | 2016-02-08 |
1558757476 | Good Night Medical of Ohio, LLC | Durable Medical Equipment & Medical Supplies | 3000 Military Rd Ste 1, Benton, AR 72015-2734 | 2015-04-07 |
1841639960 | Village Apothecary, Inc. | Durable Medical Equipment & Medical Supplies | 134 S George, Mt Ida, AR 71953 | 2013-06-21 |
1154680544 | Little Rock Respiratory | Durable Medical Equipment & Medical Supplies | 15001 Chicopee Trl, Little Rock, AR 72210-3232 | 2012-05-07 |
1639435464 | Faith Medical Incorporated | Durable Medical Equipment & Medical Supplies | 1360 S Constitution Ave, Ashdown, AR 71822-8652 | 2012-04-05 |
1689969891 | Lindsey's Respiratory, L.l.c | Durable Medical Equipment & Medical Supplies | 103 N Bailey St, Monticello, AR 71655-4907 | 2011-06-15 |
1437458031 | George Myers | Durable Medical Equipment & Medical Supplies | 114 E Crandall Ave Ste A, Harrison, AR 72601-3628 | 2011-03-22 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.