SOUTHERN HOME MEDICAL LLC (NPI# 1598037632) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598037632 |
| Entity Type | Organization |
| Organization Name | SOUTHERN HOME MEDICAL LLC |
| Practice Address |
72 Kent Rd Suite 6 Tifton GA 31794-1694 |
| Practice Telephone | 2293965501 |
| Practice Fax Number | 2293965503 |
| Mailing Telephone | 2293965501 |
| Mailing Fax Number | 2293965503 |
| Enumeration Date | 2012-02-06 |
| Last Update Date | 2012-08-17 |
| Authorized Official Name | MR. MICHAEL RAYMOND CONNELL (OWNER) |
| Authorized Official Telephone | 2293920194 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332BX2000X |
Durable Medical Equipment & Medical Supplies Specialization: Oxygen Equipment & Supplies |
GA | Suppliers |
| Street Address |
72 KENT RD SUITE 6 |
| City | TIFTON |
| State | GA |
| Zip Code | 31794-1694 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356524359 | Amedisys Georgia, L.L.C. | Home Health | 72 Kent Rd, Ste 3, Tifton, GA 31794-1695 | 2007-12-12 |
| 1801301627 | Jessica Ann Boyd | Nurse Practitioner | 72 Kent Rd, Tifton, GA 31794-1694 | 2017-12-04 |
| 1780058677 | Nalitia Zow | Nurse Practitioner | 72 Kent Rd, Unit 4, Tifton, GA 31794-1694 | 2015-11-16 |
| 1811397060 | Irwin County Hospital | Obstetrics & Gynecology | 72 Kent Rd, Tifton, GA 31794-1694 | 2014-08-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982234043 | Deloris Lunsford | Licensed Practical Nurse | 903 Washington St., Tifton, GA 31794 | 2020-01-17 |
| 1194383075 | William Jordan Kinnett | Registered Nurse | 1205 Tift Ave N, Tifton, GA 31794 | 2019-06-05 |
| 1598321200 | Courtlyn Christanna Fussell | Pharmacist | 2201 Hwy 41 N, Tifton, GA 31794 | 2019-05-17 |
| 1376027722 | Martha Gibbs | Nurse Practitioner | Affinity Clinic/west Campus, 2225 Us Hwy 41 North, Tifton, GA 31794 | 2018-09-21 |
| 1427541044 | Rebekah F Cottle | Speech-Language Pathologist | 2227 Highway 41 North, Tifton, GA 31794 | 2018-06-08 |
| 1790280857 | Tift Regional Health System Inc | Ophthalmology | 1803 Old Ocilla Road, Tifton, GA 31794 | 2018-03-29 |
| 1568975431 | Skyler Clark | Pharmacist | 2201 North 12th Street, Tifton, GA 31794 | 2017-11-14 |
| 1538606306 | Imagine Peace Counseling LLC | Counselor | 223 E 2nd Street, Suite B, Tifton, GA 31794 | 2017-01-31 |
| 1073056347 | Jessica Tumbling | Contractor | 219 Savannah Way, Tifton, GA 31794 | 2016-11-18 |
| 1992159503 | Joseph Thomas Seagraves Jr. | Nurse Practitioner | 901 East 18th Street, Tifton, GA 31794 | 2016-04-20 |
| Find all providers in zip 31794 | ||||
| Taxonomy Code | 332BX2000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| Specialization | Oxygen Equipment & Supplies |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528026226 | Life Line Home Care Inc | Durable Medical Equipment & Medical Supplies | 1610 Madison Ave, Tifton, GA 31794-3756 | 2006-05-02 |
| 1477556777 | Mrs Homecare, Inc. | Durable Medical Equipment & Medical Supplies | 1497 Kennedy Rd, Tifton, GA 31794-4159 | 2005-05-31 |
| 1952411167 | Apria Healthcare LLC | Durable Medical Equipment & Medical Supplies | 2020 Pineview Ave, Tifton, GA 31794-3035 | 2006-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790382547 | At Home Medical, Inc. | Durable Medical Equipment & Medical Supplies | 1302 Lafayette Pkwy Ste D, Lagrange, GA 30241-2611 | 2020-10-05 |
| 1427679661 | T E A M Medical LLC | Durable Medical Equipment & Medical Supplies | 3771 Monticello St, Douglasville, GA 30135-7722 | 2020-04-28 |
| 1306483003 | Family Home Medical Equipment, LLC | Durable Medical Equipment & Medical Supplies | 2601 Parkwood Dr Ste D, Brunswick, GA 31520-4724 | 2019-12-02 |
| 1518519479 | Ogles Oxygen, LLC | Durable Medical Equipment & Medical Supplies | 5021 Mercer University Dr Ste D4, Macon, GA 31210-6226 | 2019-07-11 |
| 1306403639 | Trinity Healthcare of Winston-salem, Inc. | Durable Medical Equipment & Medical Supplies | 572 Peachtree Pkwy Ste 3, Cumming, GA 30041-5800 | 2019-05-22 |
| 1417416827 | Accucare Medical Equipment, LLC | Durable Medical Equipment & Medical Supplies | 1601 Fair Rd Ste 1200, Statesboro, GA 30458-0801 | 2019-03-15 |
| 1376009118 | Meadows Healthcare Alliance, Inc. | Durable Medical Equipment & Medical Supplies | 1525 Fair Rd Ste 105, Statesboro, GA 30458-6118 | 2019-02-18 |
| 1306301841 | Altamaha Dme, Inc | Durable Medical Equipment & Medical Supplies | 1557 Pooler Parkway, Suite 300, Pooler, GA 31322 | 2019-02-08 |
| 1750866174 | Envip Medical Supplies | Durable Medical Equipment & Medical Supplies | 130 Eagle Spring Ct Ste D, Stockbridge, GA 30281-7252 | 2018-10-02 |
| 1538645502 | Lawrence Medical Supplies | Durable Medical Equipment & Medical Supplies | 1581 Lester Rd Nw Ste B8, Conyers, GA 30012-3950 | 2018-07-12 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.