Provider Demographics
NPI:1861857591
Name:ANDRE CURRY
Entity Type:Organization
Organization Name:ANDRE CURRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AGENT
Authorized Official - Prefix:
Authorized Official - First Name:ANDRE
Authorized Official - Middle Name:
Authorized Official - Last Name:CURRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-392-1166
Mailing Address - Street 1:1052 HIGHLAND COLONY PKWY STE 101
Mailing Address - Street 2:
Mailing Address - City:RIDGELAND
Mailing Address - State:MS
Mailing Address - Zip Code:39157-8782
Mailing Address - Country:US
Mailing Address - Phone:662-392-1166
Mailing Address - Fax:
Practice Address - Street 1:1052 HIGHLAND COLONY PKWY STE 101
Practice Address - Street 2:
Practice Address - City:RIDGELAND
Practice Address - State:MS
Practice Address - Zip Code:39157-8782
Practice Address - Country:US
Practice Address - Phone:662-392-1166
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-22
Last Update Date:2015-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS407149251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS8536951Medicare Oscar/Certification