MEDICARE: HOSPICE PROVIDERS, 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	315D00000X	Inpatient Hospice	067	MS

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	:	1518267442
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOSPICE PROVIDERS, LLC

Provider Business Mailing Address
First Line	:	13 NORTHTOWN DR
Second Line	:	SUITE 220
City	:	JACKSON
State	:	MS
Zip	:	39211-3047
Country	:	US
Telephone Number	:	601-956-8276
Fax Number	:	601-709-0832

Provider Business Practice Location Address
First Line	:	242 THAGGARD RD
Second Line	:
City	:	CARTHAGE
State	:	MS
Zip	:	39051-9517
Country	:	US
Telephone Number	:	601-267-6830
Fax Number	:	601-267-6690

Authorized Official
Title or Position	:	MEMBER
Name	:	REBECCA SHELTON
Credential	:
Telephone Number	:	601-956-8276

Provider Enumeration Date	:	10/26/2010
Last Update Date	:	10/26/2010

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Directions to “HOSPICE PROVIDERS, LLC ” Practice Location

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