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General NPI Number Information
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NPI Number | 1184924318
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Entity Type | Organization
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Legal Business Name | HOSPICE PROVIDERS, LLC
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Dates
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Enumeration Date | 10/21/2010
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Last Update Date | 10/21/2010
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Provider Practice Location Address
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Address Line | 402 5TH AVE SW
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City | MAGEE
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State | MS
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Zip | 39111-3950
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Country | US
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Telephone | 601-849-5903
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Fax | 601-849-5346
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Provider Business Mailing Address
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Address Line | 13 NORTHTOWN DR SUITE 220
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City | JACKSON
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State | MS
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Zip | 39211-3047
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Country | US
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Telephone | 601-956-8276
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Fax | 601-709-0832
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Authorized Official
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Title or Position | MEMBER
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Name | REBECCA SHELTON
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Credential |
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Telephone | 601-956-8276
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 315D00000X
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Taxonomy Name | Inpatient Hospice
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License Number | 140
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License Number State | MS
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