Organization
HOME ADVANTAGE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLIFF SHIRRELL (VICE PRESIDENT)
(573) 471-1276
Entity
Organization
Contact information
Practice address
731 N MAIN ST, SIKESTON, MO 63801-2151
(573) 471-1276
Mailing address
731 N MAIN ST, P.O. BOX 1210, SIKESTON, MO 63801-2151
Taxonomy
Speciality
Code
Description
License number
State
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
628964801
—
MO
Enumeration date
07/07/2006
Last updated
11/24/2008
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