CCMA, MEDICAL DATA Mable C Purnell, NPI 1720676422
Home Health Agency in Jackson, MS, US

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NPI number: what is it?

The NPI, or National Provider Identifier, is a non-repeatable number for health care providers. The NPI always consists of 10 digits and is used for administrative and financial procedures. The NPI wa...

NPI 1720676422
NPI Entity Type Individual
Provider Name CCMA, MEDICAL DATA Mable C Purnell
Enumeration Date September 30, 2009
Last Update Date September 30, 2009
Certification Date September 30, 2009
Provider Location Address 2460 Terry Rd Ste 350, Jackson, MS, US
Provider Mailing Address 1192 Harvey Cir, Bolton, MS, US, 390419471
Gender Female
Is Sole Proprietor? Yes
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Primary Taxonomy

Taxonomy Code

251E00000X

Taxonomy Name Home Health Agency
Classification

Home Health

Group

Agencies

License No. Z3X2A4K5
License State MS
Description A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.

Business Address

CCMA, MEDICAL DATA Mable C Purnell
2460 Terry Rd Ste 350

Jackson, MS, US

Phone: 601-946-3926

Mailing Address

CCMA, MEDICAL DATA Mable C Purnell
1192 Harvey Cir
Bolton, MS, US
ZIP 390419471
Phone: 601-946-3926

Other Identifiers

Identifier Identifier State Identifier Issuer Type/Code
84-5046661 MS PRIVATE INSURANCE 01
84-5046661 MS MEDICAID 05

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IDD WAIVER SERVICES Pamela Mcandrews

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