MEDICARE: QUALITY HOSPICE CARE, INC

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	086	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	:	1902805161
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	QUALITY HOSPICE CARE, INC

Provider Business Mailing Address
First Line	:	340 BYRD AVE S
Second Line	:
City	:	PHILADELPHIA
State	:	MS
Zip	:	39350-2516
Country	:	US
Telephone Number	:	601-656-5252
Fax Number	:	601-656-5253

Provider Business Practice Location Address
First Line	:	340 BYRD AVE S
Second Line	:
City	:	PHILADELPHIA
State	:	MS
Zip	:	39350-2516
Country	:	US
Telephone Number	:	601-656-5252
Fax Number	:	601-656-5253

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. JOANN T. ROUNSAVILLE
Credential	:	LBSW
Telephone Number	:	601-656-5252

Provider Enumeration Date	:	07/19/2005
Last Update Date	:	08/14/2007

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