Healthcare Provider Details

I. General information

NPI: 1902105976
Provider Name (Legal Business Name): MERCY HOSPICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2011
Last Update Date: 10/12/2025
Certification Date: 10/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 STARK RD
STARKVILLE MS
39759-3556
US

IV. Provider business mailing address

PO BOX 2130
DAPHNE AL
36526-2130
US

V. Phone/Fax

Practice location:
  • Phone: 662-338-0007
  • Fax: 662-338-0025
Mailing address:
  • Phone: 206-652-6167
  • Fax: 205-652-9110

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number151
License Number StateMS

VIII. Authorized Official

Name: LEWIS C. BLAIR
Title or Position: CEO
Credential:
Phone: 205-652-6167