MEDICARE: CMP CAP SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	HC4017	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114363272
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CMP CAP SERVICES

Provider Business Mailing Address
First Line	:	122-A NORTH RUTHERFORD STREET
Second Line	:	SUITE A
City	:	WADESBORO
State	:	NC
Zip	:	28170-2131
Country	:	US
Telephone Number	:	704-694-2028
Fax Number	:

Provider Business Practice Location Address
First Line	:	122-A NORTH RUTHERFORD STREET
Second Line	:	SUITE A
City	:	WADESBORO
State	:	NC
Zip	:	28170-2131
Country	:	US
Telephone Number	:	704-694-2028
Fax Number	:

Authorized Official
Title or Position	:	AGENCY DIRECTOR
Name	:	MRS. ELLA STURDIVANT PERRY
Credential	:
Telephone Number	:	704-694-2028

Provider Enumeration Date	:	05/16/2013
Last Update Date	:	05/16/2013

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