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NPI Code Detail

MEDICARE: COMMUNITY HEALTHCARE CONNECTIONS PERSONAL CARE SERVICES

MEDICARE: COMMUNITY HEALTHCARE CONNECTIONS PERSONAL CARE 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
1253Z00000XIn Home Supportive Care Agency

Other Identifiers

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

General Provider Information

NPI Number : 1740530559
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMMUNITY HEALTHCARE CONNECTIONS PERSONAL CARE SERVICES
Provider Business Mailing Address
First Line : 5128 OLD HIGHWAY 11 STE 10
Second Line :
City : HATTIESBURG
State : MS
Zip : 39402-6234
Country : US
Telephone Number : 601-599-0006
Fax Number : 601-599-0007
Provider Business Practice Location Address
First Line : 5128 OLD HIGHWAY 11 STE 10
Second Line :
City : HATTIESBURG
State : MS
Zip : 39402-6234
Country : US
Telephone Number : 601-599-0006
Fax Number : 601-599-0007
Authorized Official
Title or Position : CFO
Name : MRS. SHERMANDA BRUMFIELD
Credential :
Telephone Number : 601-599-0006
Provider Enumeration Date : 09/19/2012
Last Update Date : 09/19/2012

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