Healthcare Provider Details

I. General information

NPI: 1801992276
Provider Name (Legal Business Name): INFINITY HOSPICE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2006
Last Update Date: 01/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

206 N VAN BUREN ST
CARTHAGE MS
39051-3746
US

IV. Provider business mailing address

PO BOX 186
SEBASTOPOL MS
39359-0186
US

V. Phone/Fax

Practice location:
  • Phone: 601-298-0060
  • Fax: 601-298-0065
Mailing address:
  • Phone: 601-298-0060
  • Fax: 601-298-0065

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number144
License Number StateMS

VIII. Authorized Official

Name: MR. STEPHEN FORREST ADCOCK
Title or Position: PRESIDENT
Credential:
Phone: 601-298-0060