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General NPI Number Information
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NPI Number | 1851874994
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Entity Type | Organization
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Legal Business Name | P-CARES MEDICAL SUPPLIES, LLC
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Dates
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Enumeration Date | 09/14/2018
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Last Update Date | 09/14/2018
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Provider Practice Location Address
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Address Line | 3476 RIVER RD
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City | FAYETTE
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State | MS
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Zip | 39069-4602
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Country | US
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Telephone | 601-597-4840
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Fax |
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Provider Business Mailing Address
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Address Line | 3476 RIVER RD
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City | FAYETTE
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State | MS
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Zip | 39069-4602
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Country | US
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Telephone | 601-597-4840
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Fax |
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Authorized Official
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Title or Position | CEO / DIRECTOR
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Name | MR. ALFORD PERRYMAN
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Credential |
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Telephone | 601-786-0888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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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 | 376K00000X
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Taxonomy Name | Nurse's Aide
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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 | 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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