Organization
IV CARE INC
Active
Other names
Tyson HomeCare
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHERRI S. HEATON (OPERATIONS MANAGER)
(662) 252-6179
Entity
Organization
Contact information
Practice address
149 A SOUTH MARKET STREET, HOLLY SPRINGS, MS 38635-3238
(662) 252-3688
(662) 252-4379
Mailing address
530 JM ASH DRIVE, HOLLY SPRINGS, MS 38635
(662) 252-2446
(662) 252-4379
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
E06294
MS
332BX2000X
Oxygen Equipment & Supplies (DME)
07543/11.1
MS
333600000X
Pharmacy
Primary
07543-11-1
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03186562
—
MS
Enumeration date
01/02/2008
Last updated
03/25/2011
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