Healthcare Provider Details

I. General information

NPI: 1699397299
Provider Name (Legal Business Name): SHEPHERD HOSPICE CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2020
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 W BANKHEAD ST
NEW ALBANY MS
38652-3313
US

IV. Provider business mailing address

106 W BANKHEAD ST
NEW ALBANY MS
38652-3313
US

V. Phone/Fax

Practice location:
  • Phone: 662-539-7123
  • Fax: 662-539-7086
Mailing address:
  • Phone: 662-539-7086
  • Fax: 662-539-7123

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code315D00000X
TaxonomyInpatient Hospice
License Number
License Number State

VIII. Authorized Official

Name: WENDY GORE
Title or Position: CEO
Credential:
Phone: 601-842-6497