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General NPI Number Information
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NPI Number | 1720039092
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Entity Type | Organization
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Legal Business Name | TRINITY HOSPICE OF MISSISSIPPI, LLC
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Dates
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Enumeration Date | 05/12/2006
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Last Update Date | 08/23/2007
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Provider Practice Location Address
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Address Line | 201 METHODIST BLVD
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City | HATTIESBURG
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State | MS
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Zip | 39402-1297
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Country | US
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Telephone | 228-875-3527
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Fax | 214-432-9220
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Provider Business Mailing Address
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Address Line | 14180 DALLAS PKWY SUITE 800
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City | DALLAS
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State | TX
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Zip | 75254-4341
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Country | US
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Telephone | 214-306-4520
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Fax | 972-386-0704
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | AMY MARIE GLASSCOCK
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Credential |
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Telephone | 214-306-4520
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | 035
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License Number State | MS
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