Healthcare Provider Details

I. General information

NPI: 1275879314
Provider Name (Legal Business Name): KEMPER CAH, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2012
Last Update Date: 06/21/2023
Certification Date: 06/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4331 HIGHWAY 39 N
MERIDIAN MS
39301-1007
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 601-484-6180
  • Fax: 601-482-0944
Mailing address:
  • Phone: 601-213-3010
  • Fax: 601-213-3011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

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