MEDICARE: INFINITY ENTERPRISE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	1154241	AL
2	251J00000X	Nursing Care Agency
3	253Z00000X	In Home Supportive Care Agency
4	343900000X	Non-emergency Medical Transport (VAN)
5	385HR2055X	Child Mental Illness Respite Care
6	385HR2060X	Child Intellectual and/or Developmental Disabilities Respite Care
7	385HR2065X	Child Physical Disabilities Respite Care
8	163W00000X	Registered Nurse	R877178	MS

General Provider Information

NPI Number	:	1124547542
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INFINITY ENTERPRISE LLC

Provider Business Mailing Address
First Line	:	64 FIRST COLONY CIR
Second Line	:
City	:	COLUMBUS
State	:	MS
Zip	:	39702-7900
Country	:	US
Telephone Number	:	662-435-5404
Fax Number	:

Provider Business Practice Location Address
First Line	:	64 FIRST COLONY CIR
Second Line	:
City	:	COLUMBUS
State	:	MS
Zip	:	39702-7900
Country	:	US
Telephone Number	:	662-435-5404
Fax Number	:

Authorized Official
Title or Position	:	OWNER/CEO
Name	:	MRS. ROSHUNICA ROCHELLE MURRAY
Credential	:	RN
Telephone Number	:	662-435-5404

Provider Enumeration Date	:	09/18/2017
Last Update Date	:	09/18/2017

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Directions to “INFINITY ENTERPRISE LLC ” Practice Location

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