Healthcare Provider Details

I. General information

NPI: 1427009067
Provider Name (Legal Business Name): A & E HOSPICE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2006
Last Update Date: 03/31/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6810 CRUMPLER BLVD
OLIVE BRANCH MS
38654-1933
US

IV. Provider business mailing address

PO BOX 1332
FLORENCE AL
35631-1332
US

V. Phone/Fax

Practice location:
  • Phone: 256-764-6633
  • Fax: 256-764-7873
Mailing address:
  • Phone: 256-764-6633
  • Fax: 256-764-7873

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number009
License Number StateMS

VIII. Authorized Official

Name: MR. CHARLES A EDDINS
Title or Position: OWNER
Credential:
Phone: 256-764-6633