E & D Private Care Agency

Primary specialty

Personal Care AttendantTaxonomy code 3747P1801X

Legal business name

E & D PRIVATE CARE AGENCY

Practice address

3051 Waverly Rd
Proctor, AR 72376

Phone

(901) 262-6043

Fax

(870) 400-0061

NPI assigned

Oct 8, 2019

Last updated

Oct 8, 2019By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Darrell L. Mack

Title

Owner

Phone

(870) 514-2218

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1570492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570492800000",
    "number": "1417599788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3051 WAVERLY RD",
            "city": "PROCTOR",
            "state": "AR",
            "postal_code": "72376",
            "telephone_number": "901-262-6043",
            "fax_number": "870-400-0061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3051 WAVERLY RD",
            "city": "PROCTOR",
            "state": "AR",
            "postal_code": "72376",
            "telephone_number": "901-262-6043",
            "fax_number": "870-400-0061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "E & D PRIVATE CARE AGENCY",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-08",
        "last_updated": "2019-10-08",
        "status": "A",
        "authorized_official_last_name": "MACK",
        "authorized_official_first_name": "DARRELL",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "870-514-2218",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evelyn McQueen
• Terrys Residential Care Facility
• These Old Bonez Enterprises

• Personal Care Attendant in Proctor, AR
• Providers in Proctor, AR by specialty
• Personal Care Attendant in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.