NPIMap

Organization Active NPI

Mrs Homecare, Inc.

Doing business as Mrs of Fitzgerald

  • Oxygen Equipment & Supplies (DME)
  • Fitzgerald, GA
National Provider Identifier
1821090135
Registry record updated May 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X
Legal business name
MRS HOMECARE, INC.
Doing business as
Mrs of Fitzgerald
Practice address
104 Norman Dorminy Dr
Fitzgerald, GA 31750-8858
Phone
(229) 423-4545
Fax
(229) 423-8610
NPI assigned
Jun 1, 2005
Last updated
May 9, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. E Thomas Riddle
Title
President
Phone
(229) 439-2403

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oxygen Equipment & Supplies (DME) 332BX2000X NU Primary

Addresses

Primary practice location

104 Norman Dorminy Dr
Fitzgerald, GA 31750-8858

Mailing address

PO Box 568
Albany, GA 31702-0568
Phone (229) 439-2403

Other identifiers 1

IdentifierTypeStateIssuer
000238697HMedicaidGA

Other names 1

  • MRS OF FITZGERALD Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930051764 GA DME Supplier - Medical Supply CompanyDME Supplier - Oxygen & Equipment 7810015575 Practice locations: Fitzgerald, GA

Other NPIs with the same Medicare PAC ID 12

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Mrs Homecare, Inc.104 Norman Dorminy Dr, Fitzgerald, GA 31750-8858(229) 423-4545 Commodes, Urinals, Bedpans|Continuous Passive Motion (CPM) Devices|Contracture Treatment Devices: Dynamic Splint|Blood Glucose Monitors/Supplies (Non-Mail Order)|Gastric Suction Pumps|Heat & Cold Applications|Hospital Beds (Electric)|Hospital Beds (Manual)|Negative Pressure Wound Therapy Pumps/Supp… Does not accept assignmentParticipating since Jan 1, 1998

National Provider Directory

National Provider Directory
Tax ID family
Nashville Mrs15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

Locations

104 Norman Dorminy Dr
Fitzgerald, GA 31750
Phone (229) 423-4545

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336521600000",
    "number": "1821090135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 568",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317020568",
            "telephone_number": "229-439-2403",
            "fax_number": "229-883-8426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 NORMAN DORMINY DR",
            "city": "FITZGERALD",
            "state": "GA",
            "postal_code": "317508858",
            "telephone_number": "229-423-4545",
            "fax_number": "229-423-8610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MRS HOMECARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-01",
        "last_updated": "2012-05-09",
        "status": "A",
        "authorized_official_last_name": "RIDDLE",
        "authorized_official_first_name": "E",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "229-439-2403",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000238697H",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MRS OF FITZGERALD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fitzgerald, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.