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NPI Code Detail

MEDICARE: ST JOSEPH HOSPICE OF SOUTHERN MISSISSIPPI, LLC

MEDICARE: ST JOSEPH HOSPICE OF SOUTHERN MISSISSIPPI, 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
1251G00000XCommunity Based Hospice Care AgencyAPPLIEDMS

General Provider Information

NPI Number : 1356625008
Entity Type Code : Organization
Provider Name (Legal Business Name) : ST JOSEPH HOSPICE OF SOUTHERN MISSISSIPPI, LLC
Provider Business Mailing Address
First Line : 10615 JEFFERSON HWY
Second Line :
City : BATON ROUGE
State : LA
Zip : 70809-7230
Country : US
Telephone Number : 225-769-2449
Fax Number : 225-757-1104
Provider Business Practice Location Address
First Line : 32 MILLBRANCH RD STE 30
Second Line :
City : HATTIESBURG
State : MS
Zip : 39402-1673
Country : US
Telephone Number : 601-261-2515
Fax Number : 601-261-2788
Authorized Official
Title or Position : MANAGING MEMBER
Name : PATRICK T MITCHELL
Credential :
Telephone Number : 225-769-2449
Provider Enumeration Date : 09/29/2011
Last Update Date : 06/26/2020

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Directions to “ST JOSEPH HOSPICE OF SOUTHERN MISSISSIPPI, LLC ” Practice Location

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