Healthcare Provider Details

I. General information

NPI: 1891232104
Provider Name (Legal Business Name): KAMKADE ENTERPRISES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2017
Last Update Date: 10/01/2024
Certification Date: 10/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4814 LAKELAND DR # A
FLOWOOD MS
39232-8694
US

IV. Provider business mailing address

PO BOX 320234
FLOWOOD MS
39232-0234
US

V. Phone/Fax

Practice location:
  • Phone: 769-251-5006
  • Fax: 769-251-5006
Mailing address:
  • Phone: 769-251-5006
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number State

VIII. Authorized Official

Name: DEQUARIUS T DUNSON
Title or Position: MANAGING DIRECTOR
Credential: B.S
Phone: 769-251-5006