Healthcare Provider Details

I. General information

NPI: 1376588939
Provider Name (Legal Business Name): HEART TO HEART HOSPICE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

278 HIGHWAY 366
BELMONT MS
38827-7751
US

IV. Provider business mailing address

PO BOX 875 278 HWY. 366 EAST
BELMONT MS
38827-0875
US

V. Phone/Fax

Practice location:
  • Phone: 662-454-3632
  • Fax: 662-454-0281
Mailing address:
  • Phone: 662-454-3632
  • Fax: 662-454-0281

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number065
License Number StateMS

VIII. Authorized Official

Name: MR. JOHN HICKS
Title or Position: CFO
Credential:
Phone: 901-854-6185