E & D PRIVATE CARE AGENCY (NPI# 1417599788) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417599788 |
| Entity Type | Organization |
| Organization Name | E & D PRIVATE CARE AGENCY |
| Practice Address |
3051 Waverly Rd Proctor AR 72376 |
| Practice Telephone | 9012626043 |
| Practice Fax Number | 8704000061 |
| Mailing Telephone | 9012626043 |
| Mailing Fax Number | 8704000061 |
| Enumeration Date | 2019-10-08 |
| Last Update Date | 2019-10-08 |
| Authorized Official Name | MR. DARRELL L. MACK (OWNER) |
| Authorized Official Telephone | 8705142218 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3747P1801X |
Technician Specialization: Personal Care Attendant |
Nursing Service Related Providers |
| Street Address |
3051 WAVERLY RD |
| City | PROCTOR |
| State | AR |
| Zip Code | 72376 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063919892 | These Old Bonez Enterprises | Home Health | 2144 Hwy147 South- Building A, Proctor, AR 72376-2346 | 2018-04-09 |
| 1689712036 | Terrys Residential Care Facility | Custodial Care Facility | 283 Hinkley Rd, Proctor, AR 72376-8804 | 2007-02-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699315234 | Brian Steven Hammers | Counselor | 810 Almac Dr, Proctor, MN 55810-2743 | 2020-01-12 |
| 1720541337 | Ltc Prescription Providers #2 | Pharmacy | 220 1/2 Third Avenue, Proctor, MN 55810 | 2019-04-10 |
| 1245628742 | Andrea Mckay | Specialist/Technologist | 1226 2nd Ave, Proctor, MN 55810-1218 | 2015-01-06 |
| 1083012165 | Fcsl Proctor, LLC | Assisted Living Facility | 913 Old Highway 2, Proctor, MN 55810-1750 | 2014-12-05 |
| 1609274794 | Fcsl Proctor, LLC | Assisted Living Facility | 919 Old Highway 2, Proctor, MN 55810-1750 | 2014-12-05 |
| 1992103089 | Fcsl Proctor, LLC | Assisted Living Facility | 921 Old Highway 2, Proctor, MN 55810-1750 | 2014-12-05 |
| 1598162646 | Fcsl Proctor, LLC | Assisted Living Facility | 923 Old Highway 2, Proctor, MN 55810-1750 | 2014-12-04 |
| 1083014708 | Kristen O'neil | Specialist/Technologist | 40 Postal St, Proctor, WV 26055-1316 | 2014-08-29 |
| 1467875849 | Sherry Simpauco | Registered Nurse | 806 Almac Dr, Proctor, MN 55810-2743 | 2014-01-21 |
| 1053655910 | Christopher Dixon Brown | Health Educator | 1013 Acacia Ave, Proctor, MN 55810-2632 | 2012-11-15 |
| Find all providers in PROCTOR | ||||
| Taxonomy Code | 3747P1801X |
| Grouping | Nursing Service Related Providers |
| Classification | Technician |
| Specialization | Personal Care Attendant |
| An individual who provides assistance with eating, bathing, dressing, personal hygiene, activities of daily living as specified in the plan of care. Services which are incidental to the care furnished, or essential to the health and welfare of the individual may also be provided. Personal care providers must meet state defined training and certification standards |
| Notes: [7/1/2003: definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154922540 | Home Health Care Agency of Arkansas, LLC | Technician | 1200 John Barrow Rd Ste 111, Little Rock, AR 72205-6528 | 2020-11-03 |
| 1770110488 | Roger Barnes | Technician | 4836 Park Ave Ste B, Hot Springs, AR 71901-9477 | 2020-03-24 |
| 1184259210 | Little Joe Scott | Technician | 2702 Amhurst, Magnolia, AR 71753-4216 | 2020-03-09 |
| 1598303968 | Brandon Lee Hutchison | Technician | 152 Birchwood Cir, Cabot, AR 72023-2585 | 2019-12-17 |
| 1275184749 | Home Care Network LLC | Technician | 2607 W 28th Ave, Pine Bluff, AR 71603-4916 | 2019-09-25 |
| 1720639347 | Always Promoting Independence Homecare, LLC | Technician | 1004 Brantley Ave, North Little Rock, AR 72117-2146 | 2019-09-25 |
| 1235784893 | Elite Care, LLC | Technician | 130 West 2nd St., Malvern, AR 72104-3708 | 2019-08-09 |
| 1245791094 | Kim Callicutt | Technician | 110 Block St, Marion, AR 72364-1956 | 2019-03-26 |
| 1912468711 | Eden House Home Care, LLC | Technician | 120 W Tyler Ave Ste 200, West Memphis, AR 72301-4221 | 2019-03-26 |
| 1760992911 | Lorraine Irene Devries | Technician | 1316 Industrial Acess Drive, Trumann, AR 72472 | 2017-10-02 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.