1124235494 NPI number — CAROL'S HOSPICE & PALLIATIVE SERVICES OF SHELBY, MISSISSIPPI, INC.

Table of content: DR. STANLEY MARK STEINERMAN DDS (NPI 1326180472)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124235494 NPI number — CAROL'S HOSPICE & PALLIATIVE SERVICES OF SHELBY, MISSISSIPPI, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CAROL'S HOSPICE & PALLIATIVE SERVICES OF SHELBY, MISSISSIPPI, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1124235494
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/19/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
163 N MAIN ST
Provider Second Line Business Mailing Address:
P.O. BOX 23
Provider Business Mailing Address City Name:
DREW
Provider Business Mailing Address State Name:
MS
Provider Business Mailing Address Postal Code:
38737-3406
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
662-745-6100
Provider Business Mailing Address Fax Number:
662-745-0503

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
163 N MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DREW
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
38737-3406
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
662-745-6100
Provider Business Practice Location Address Fax Number:
662-745-0503
Provider Enumeration Date:
05/17/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
LAMBERT
Authorized Official First Name:
PAULA
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
662-588-0699

Provider Taxonomy Codes

  • Taxonomy code: 251G00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 01389063 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".