Healthcare Provider Details

I. General information

NPI: 1043258478
Provider Name (Legal Business Name): ASERACARE HOSPICE - MERIDIAN, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4825 POPLAR SPRINGS DR
MERIDIAN MS
39305-2625
US

IV. Provider business mailing address

4825 POPLAR SPRINGS DR
MERIDIAN MS
39305-2625
US

V. Phone/Fax

Practice location:
  • Phone: 901-758-1450
  • Fax:
Mailing address:
  • Phone: 901-758-1450
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code315D00000X
TaxonomyInpatient Hospice
License Number
License Number State

VIII. Authorized Official

Name: HOLLY A JONES
Title or Position: SECRETARY
Credential:
Phone: 479-201-4840