MEDICARE: EMILY MCCAIN CPT

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	246RP1900X	Phlebotomy Technician	037865-PT15	MS

General Provider Information

NPI Number	:	1811435837
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY MCCAIN CPT

Provider Business Mailing Address
First Line	:	1010 N YALE ST
Second Line	:
City	:	CLEVELAND
State	:	MS
Zip	:	38732-3660
Country	:	US
Telephone Number	:	662-588-6231
Fax Number	:

Provider Business Practice Location Address
First Line	:	1010 N YALE ST
Second Line	:
City	:	CLEVELAND
State	:	MS
Zip	:	38732-3660
Country	:	US
Telephone Number	:	662-588-6231
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/09/2017
Last Update Date	:	02/09/2017

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