Healthcare Provider Details

I. General information

NPI: 1194255570
Provider Name (Legal Business Name): C & C NURSING COMPANY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2017
Last Update Date: 11/16/2023
Certification Date: 11/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2425 S PEARSON RD
PEARL MS
39208-9443
US

IV. Provider business mailing address

PO BOX 515
TERRY MS
39170-0515
US

V. Phone/Fax

Practice location:
  • Phone: 601-983-7168
  • Fax: 769-257-5659
Mailing address:
  • Phone: 601-983-7168
  • Fax: 769-251-1295

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: CANDACE THOMAS HARVEY
Title or Position: CEO
Credential:
Phone: 601-983-7168