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General NPI Number Information
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NPI Number | 1487416202
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Entity Type | Organization
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Legal Business Name | MDP HOME HEALTH
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Dates
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Enumeration Date | 01/26/2024
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Last Update Date | 01/26/2024
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Provider Practice Location Address
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Address Line | 530 MCNEESE DR
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City | NESBIT
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State | MS
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Zip | 38651-6034
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Country | US
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Telephone | 901-501-2578
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Fax |
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Provider Business Mailing Address
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Address Line | 530 MCNEESE DR
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City | NESBIT
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State | MS
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Zip | 38651-6034
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Country | US
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Telephone | 901-501-2578
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MARILYN D PERRY
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Credential |
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Telephone | 901-501-2579
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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