MEDICARE: CPM CASE MANAGEMENT GROUP, 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	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1902255524
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CPM CASE MANAGEMENT GROUP, LLC

Provider Business Mailing Address
First Line	:	1206 FLORIDA BLVD
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70802-4632
Country	:	US
Telephone Number	:	225-663-0191
Fax Number	:	225-239-7979

Provider Business Practice Location Address
First Line	:	1206 FLORIDA BLVD
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70802-4632
Country	:	US
Telephone Number	:	225-663-0161
Fax Number	:	225-239-7979

Authorized Official
Title or Position	:	DIRECTOR
Name	:	KENNETH ANDRE BOWIE
Credential	:
Telephone Number	:	225-663-0191

Provider Enumeration Date	:	06/04/2016
Last Update Date	:	06/04/2016

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