MEDICARE: PREFERRED HOSPICE OF MISSOURI CENTRAL LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251G00000X	Community Based Hospice Care Agency	147-HO	MO
2	251G00000X	Community Based Hospice Care Agency	147-3HO	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	213080	OTHER	MO	BLUE CROSS BLUE SHIELD
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538104914
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PREFERRED HOSPICE OF MISSOURI CENTRAL LLC

Provider Business Mailing Address
First Line	:	1220 NORTH MAIN STREET
Second Line	:
City	:	SIKESTON
State	:	MO
Zip	:	63801-4827
Country	:	US
Telephone Number	:	573-481-9625
Fax Number	:	573-481-9639

Provider Business Practice Location Address
First Line	:	1900 N PROVIDENCE ROAD
Second Line	:	SUITE 311
City	:	COLUMBIA
State	:	MO
Zip	:	65202-3710
Country	:	US
Telephone Number	:	573-499-4540
Fax Number	:	573-499-4543

Authorized Official
Title or Position	:	MEMBER
Name	:	JAMES C LINCOLN
Credential	:
Telephone Number	:	573-481-9625

Provider Enumeration Date	:	06/18/2006
Last Update Date	:	10/22/2025

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Directions to “PREFERRED HOSPICE OF MISSOURI CENTRAL LLC ” Practice Location

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