Organization
MID-SOUTH HOME CARE SERVICES, LLC
Active
Parent organization
GENTIVA HEALTH SERVICES, INC.
Other names
Mid-South Respiratory Services & HME
Organization subpart
Yes
Provider details
NPI number
Legal business name
GENTIVA HEALTH SERVICES, INC.
Authorized official
JANET COMBS (VP OF LICENSURE)
(913) 814-2013
Entity
Organization
Contact information
Practice address
2740 HEADLAND AVE, DOTHAN, AL 36303-1236
(334) 792-3200
Mailing address
12900 FOSTER ST, SUITE 400, OVERLAND PARK, KS 66213-2649
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009909965
—
AL
01
—
515-21704
G2
AL
Enumeration date
06/24/2006
Last updated
03/24/2022
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