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General NPI Number Information
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NPI Number | 1013501097
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Entity Type | Organization
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Legal Business Name | NFINITY PRIVATE DUTY HOME HEALTH LLC
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Dates
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Enumeration Date | 02/22/2021
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Last Update Date | 09/18/2025
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Provider Practice Location Address
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Address Line | 1814 COLUMBIA AVE STE B
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City | PRENTISS
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State | MS
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Zip | 39474
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Country | US
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Telephone | 601-441-3537
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 177
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City | PRENTISS
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State | MS
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Zip | 39474-0177
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Country | US
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Telephone | 844-244-2430
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Fax | 844-244-2430
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Authorized Official
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Title or Position | CEO
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Name | KIMBERLY GHOLAR
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Credential |
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Telephone | 601-441-3537
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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