Provider Demographics
NPI:1003516279
Name:JOBE, BRENDAN (HME PROVIDER)
Entity Type:Individual
Prefix:
First Name:BRENDAN
Middle Name:
Last Name:JOBE
Suffix:
Gender:M
Credentials:HME PROVIDER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:912 E 5TH ST
Mailing Address - Street 2:
Mailing Address - City:CORINTH
Mailing Address - State:MS
Mailing Address - Zip Code:38834-3562
Mailing Address - Country:US
Mailing Address - Phone:662-808-1483
Mailing Address - Fax:
Practice Address - Street 1:2033 E 3RD ST
Practice Address - Street 2:
Practice Address - City:CORINTH
Practice Address - State:MS
Practice Address - Zip Code:38834-3716
Practice Address - Country:US
Practice Address - Phone:662-808-1483
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-07
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health