MEDICARE: MEMORIAL HOSPICE AND PALLIATIVE CARE OF HAMMOND, 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	153	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457354961
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEMORIAL HOSPICE AND PALLIATIVE CARE OF HAMMOND, LLC

Provider Business Mailing Address
First Line	:	PO BOX 650
Second Line	:
City	:	MANDEVILLE
State	:	LA
Zip	:	70470-0650
Country	:	US
Telephone Number	:	985-626-3281
Fax Number	:	985-626-8773

Provider Business Practice Location Address
First Line	:	1671 HIGHWAY 51
Second Line	:
City	:	PONCHATOULA
State	:	LA
Zip	:	70454-6376
Country	:	US
Telephone Number	:	985-386-6150
Fax Number	:	985-386-6162

Authorized Official
Title or Position	:	CEO
Name	:	STEPHANIE SCHEDLER
Credential	:
Telephone Number	:	985-626-3281

Provider Enumeration Date	:	05/30/2005
Last Update Date	:	08/22/2020

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