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General NPI Number Information
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NPI Number | 1902871809
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Entity Type | Organization
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Legal Business Name | CDS HOME CARE, INC.
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Dates
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Enumeration Date | 02/22/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1911 MISSION 66 SUITE H
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City | VICKSBURG
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State | MS
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Zip | 39180-3762
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Country | US
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Telephone | 601-883-2999
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Fax | 601-883-2877
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Provider Business Mailing Address
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Address Line | 1911 MISSION 66 SUITE H
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City | VICKSBURG
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State | MS
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Zip | 39180-3762
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Country | US
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Telephone | 601-883-2999
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Fax | 601-883-2877
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Authorized Official
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Title or Position | PHARMACIST
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Name | MR. REAGAN L BROWN
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Credential | RPH
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Telephone | 601-883-2999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 05542/02.2
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 3336H0001X
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Taxonomy Name | Home Infusion Therapy Pharmacy
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License Number | 05542/02.2
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License Number State | MS
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Taxonomy #3
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Taxonomy Code | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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License Number | 05542/02.2
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License Number State | MS
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Taxonomy #4
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number | 05542/02.2
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License Number State | MS
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Taxonomy #5
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 05542/02.2
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License Number State | MS
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Taxonomy #6
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State | MS
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