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General NPI Number Information
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NPI Number | 1255401642
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Entity Type | Organization
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Legal Business Name | ST. LUKE HOME HEALTH SERVICES, LLC
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Dates
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Enumeration Date | 11/09/2006
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Last Update Date | 05/17/2017
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Provider Practice Location Address
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Address Line | 210 STATE ST
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City | MCCOMB
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State | MS
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Zip | 39648-3939
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Country | US
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Telephone | 601-249-4260
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Fax | 601-249-4292
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Provider Business Mailing Address
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Address Line | PO BOX 1103 P. O. BOX 1103
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City | MCCOMB
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State | MS
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Zip | 39649-2735
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Country | US
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Telephone | 601-249-4260
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Fax | 601-249-4292
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | NORMAN PRICE
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Credential |
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Telephone | 601-249-1807
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 6081
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License Number State | MS
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