MEDICARE: CANNDID

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

General Provider Information

NPI Number	:	1356275416
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CANNDID

Provider Business Mailing Address
First Line	:	2050 EDGEVIEW WAY # 714
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37918-1786
Country	:	US
Telephone Number	:	209-730-0435
Fax Number	:

Provider Business Practice Location Address
First Line	:	2050 EDGEVIEW WAY # 714
Second Line	:
City	:	KNOXVILLE
State	:	TN
Zip	:	37918-1786
Country	:	US
Telephone Number	:	209-730-0435
Fax Number	:

Authorized Official
Title or Position	:	COO
Name	:	CHARLES, MITCHELL
Credential	:
Telephone Number	:	209-730-0435

Provider Enumeration Date	:	06/11/2026
Last Update Date	:	06/11/2026

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Directions to “CANNDID ” Practice Location

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