Provider Demographics
NPI:1053430090
Name:MDS IN-HOME SERVICES
Entity type:Organization
Organization Name:MDS IN-HOME SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:
Authorized Official - Last Name:DIXSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-385-2275
Mailing Address - Street 1:8519 DRURY LN
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63147-1313
Mailing Address - Country:US
Mailing Address - Phone:314-385-2275
Mailing Address - Fax:314-385-2275
Practice Address - Street 1:8519 DRURY LN
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63147-1313
Practice Address - Country:US
Practice Address - Phone:314-385-2275
Practice Address - Fax:314-385-2275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Single Specialty
No372500000XNursing Service Related ProvidersChore ProviderGroup - Single Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty