# SOUTHERN HOME CARE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1831115781
- **Authorized official:** CLIFTON GANT (VP OF OPS)
- **Authorized official phone:** (662) 342-8527

## Contact information

- **Practice address:** 8865 FIRST INDUSTRIAL DR, SOUTHAVEN, MS 38671-1919
- **Practice address phone:** (662) 342-8527
- **Practice address fax:** (662) 280-3708
- **Mailing address:** PO BOX 793, CHARLESTON, MS 38921-0793

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | 926 | MS | — |
| 3336S0011X | Specialty Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 07/14/2006
- **Last updated:** 09/11/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00045117 | — | MS |
| 01 | — | 2586432 | OTHER ID NUMBER-COMMERCIAL NUMBER | — |
| 05 | — | 4581871 | — | MS |