Organization Name:  CDS HOME CARE, INC


Practice Location:
119 BOBO DR  CRYSTAL SPRINGS, MS 39059 US
Tel: 601-892-9988  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

Primary	Code	Category/Description	State	License Number
X	332BP3500X	Suppliers Durable Medical Equipment & Medical Supplies Parenteral & Enteral Nutrition	MS	04960/02.2
X	332BX2000X	Suppliers Durable Medical Equipment & Medical Supplies	MS	04960/02.2
X	3336L0003X	Suppliers Pharmacy	MS	04960/02.2
X	3336S0011X	Suppliers Pharmacy	MS	04960/02.2
X	332B00000X	Suppliers Durable Medical Equipment & Medical Supplies	MS	04960/02.2
X	3336H0001X	Suppliers Pharmacy	MS	04960/02.2

Other Provider Identifiers:

Issuer	Number	State	Type
	00330598	MS	05
NCPDP NUMBER	2520395	MS	01
	00440693	MS	05

Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin