Organization
HOMETOWN CARE OF MANTACHIE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREA CARPENTER FNP-C (OWNER)
(662) 282-7555
Entity
Organization
Contact information
Practice address
3275 HIGHWAY 371 N, MANTACHIE, MS 38855-7145
(662) 282-7555
Mailing address
3275 HWY. 371, P.O. BOX 418, MANTACHIE, MS 38855-0418
(662) 282-7555
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
01/31/2019
Last updated
08/14/2019
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