Healthcare Provider Details

I. General information

NPI: 1457934952
Provider Name (Legal Business Name): CARTHAGE SENIOR CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2021
Last Update Date: 05/11/2021
Certification Date: 05/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1065 E FRANKLIN ST
CARTHAGE MS
39051-3601
US

IV. Provider business mailing address

125 FOUNTAINS BLVD
MADISON MS
39110-6344
US

V. Phone/Fax

Practice location:
  • Phone: 601-267-1352
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: LORI WARNOCK
Title or Position: DIRECTOR OF FINANCE
Credential:
Phone: 601-499-0899