Healthcare Provider Details

I. General information

NPI: 1457568149
Provider Name (Legal Business Name): INCARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1151 NORTH STATE ST SUITE 406
JACKSON MS
39202
US

IV. Provider business mailing address

PO BOX 4199
JACKSON MS
39296
US

V. Phone/Fax

Practice location:
  • Phone: 601-353-0407
  • Fax: 601-981-1869
Mailing address:
  • Phone: 601-981-1861
  • Fax: 601-981-1869

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225B00000X
TaxonomyPulmonary Function Technologist
License Number
License Number State

VIII. Authorized Official

Name: MRS. BEVERLY A SUMRALL
Title or Position: OWNER
Credential:
Phone: 601-981-1861