MEDICARE: THE CUTTING EDGE SENIOR CARE AND SITTING SERVIC

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	3411-000-0101	AR
2	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1194026823
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE CUTTING EDGE SENIOR CARE AND SITTING SERVIC

Provider Business Mailing Address
First Line	:	1719 DODSON AVE.
Second Line	:
City	:	FT. SMITH
State	:	AR
Zip	:	72901-1719
Country	:	US
Telephone Number	:	479-434-3295
Fax Number	:	479-434-3205

Provider Business Practice Location Address
First Line	:	1719 DODSON AVE.
Second Line	:
City	:	FT. SMITH
State	:	AR
Zip	:	72901-1719
Country	:	US
Telephone Number	:	479-434-3295
Fax Number	:	479-434-3205

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. FRANKIE SUE LEVINE
Credential	:	CNA
Telephone Number	:	479-434-3295

Provider Enumeration Date	:	11/11/2010
Last Update Date	:	11/11/2010

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