Healthcare Provider Details

I. General information

NPI: 1295801785
Provider Name (Legal Business Name): UNITED HEALTHCARE AND HOSPICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2006
Last Update Date: 02/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

558 HIGHWAY 6 E SUITE A
BATESVILLE MS
38606-3002
US

IV. Provider business mailing address

558 HIGHWAY 6 E SUITE A
BATESVILLE MS
38606-3002
US

V. Phone/Fax

Practice location:
  • Phone: 662-934-2981
  • Fax:
Mailing address:
  • Phone: 662-934-2981
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number106
License Number StateMS

VIII. Authorized Official

Name: MRS. EDITH M CORKERN
Title or Position: VICE PRESIDENT
Credential: RN
Phone: 601-573-0386