MEDICARE: HOMECARE HOSPICE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251G00000X	Community Based Hospice Care Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	070221	OTHER	MS	BCBS OF MS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326118522
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOMECARE HOSPICE, LLC

Provider Business Mailing Address
First Line	:	PO BOX 2130
Second Line	:
City	:	DAPHNE
State	:	AL
Zip	:	36526-2130
Country	:	US
Telephone Number	:	205-652-6167
Fax Number	:	205-742-0028

Provider Business Practice Location Address
First Line	:	13 NORTHTOWN DR STE 130
Second Line	:
City	:	JACKSON
State	:	MS
Zip	:	39211-3047
Country	:	US
Telephone Number	:	769-257-6347
Fax Number	:	769-257-6379

Authorized Official
Title or Position	:	CEO
Name	:	MR. LEWIS CLARK BLAIR
Credential	:
Telephone Number	:	205-652-6167

Provider Enumeration Date	:	11/08/2006
Last Update Date	:	02/27/2025

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Directions to “HOMECARE HOSPICE, LLC ” Practice Location

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