Healthcare Provider Details

I. General information

NPI: 1346546306
Provider Name (Legal Business Name): KEMPER CAH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2011
Last Update Date: 04/17/2025
Certification Date: 04/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14365 HIGHWAY 16 W
DE KALB MS
39328-7974
US

IV. Provider business mailing address

DEPT. 3019, P O BOX 1000
MEMPHIS TN
38148-3019
US

V. Phone/Fax

Practice location:
  • Phone: 769-486-1000
  • Fax: 769-486-1090
Mailing address:
  • Phone: 601-213-3010
  • Fax: 601-213-3011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: DON LARKIN KENNEDY
Title or Position: REGIONAL CEO
Credential:
Phone: 601-703-9614