Healthcare Provider Details

I. General information

NPI: 1568713816
Provider Name (Legal Business Name): C&M ENTERPRISE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2012
Last Update Date: 09/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3977 BURMA RD SUITE B
MOBILE AL
36693-4523
US

IV. Provider business mailing address

3977 BURMA RD SUITE B
MOBILE AL
36693-4523
US

V. Phone/Fax

Practice location:
  • Phone: 251-660-8574
  • Fax:
Mailing address:
  • Phone: 251-660-8574
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number073435
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number073425
License Number StateAL

VIII. Authorized Official

Name: MR. CALVIN HORTON
Title or Position: PRESIDENT
Credential:
Phone: 251-660-8574