MEDICARE: NORA PEGUES

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	3747P1801X	Personal Care Attendant
2	253Z00000X	In Home Supportive Care Agency
3	261QA0600X	Adult Day Care Clinic/Center

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	:	1972202596
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NORA PEGUES

Provider Business Mailing Address
First Line	:	PO BOX 1681
Second Line	:
City	:	CLEVELAND
State	:	MS
Zip	:	38732-1681
Country	:	US
Telephone Number	:	662-843-4150
Fax Number	:	662-843-3401

Provider Business Practice Location Address
First Line	:	200 GLASSCO ST
Second Line	:
City	:	CLEVELAND
State	:	MS
Zip	:	38732-4434
Country	:	US
Telephone Number	:	662-843-4150
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/02/2023
Last Update Date	:	03/02/2023

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Directions to “ NORA PEGUES ” Practice Location

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