Healthcare Provider Details
I. General information
NPI: 1306141387
Provider Name (Legal Business Name): MERCY HOSPICE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/21/2011
Last Update Date: 03/21/2025
Certification Date: 03/21/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
183 HIGHWAY 51 S
BATESVILLE MS
38606-2542
US
IV. Provider business mailing address
PO BOX 2130
DAPHNE AL
36526-2130
US
V. Phone/Fax
- Phone: 662-578-8177
- Fax: 662-578-8175
- Phone: 205-615-6167
- Fax: 205-742-0028
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251G00000X |
| Taxonomy | Community Based Hospice Care Agency |
| License Number | 143 |
| License Number State | MS |
VIII. Authorized Official
Name:
LEWIS
CLARK
BLAIR
Title or Position: CEO
Credential:
Phone: 205-652-6167