MEDICARE: VITA TEMPUS CARE

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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1538052923
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VITA TEMPUS CARE

Provider Business Mailing Address
First Line	:	134 FAIRMONT ST STE C
Second Line	:
City	:	CLINTON
State	:	MS
Zip	:	39056-4739
Country	:	US
Telephone Number	:	769-348-3330
Fax Number	:	769-348-3351

Provider Business Practice Location Address
First Line	:	134 FAIRMONT ST STE C
Second Line	:
City	:	CLINTON
State	:	MS
Zip	:	39056-4739
Country	:	US
Telephone Number	:	769-348-3330
Fax Number	:	769-348-3351

Authorized Official
Title or Position	:	COO
Name	:	MR. JEREMY GRAY
Credential	:
Telephone Number	:	769-348-3330

Provider Enumeration Date	:	06/02/2025
Last Update Date	:	06/02/2025

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Directions to “VITA TEMPUS CARE ” Practice Location

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