1164728689 NPI number — SAINT ANTHONYS HOSPICE & PALLIATIVE CARE

Table of content: RONALD LEE ROSS R.N. (NPI 1841523099)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164728689 NPI number — SAINT ANTHONYS HOSPICE & PALLIATIVE CARE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SAINT ANTHONYS HOSPICE & PALLIATIVE CARE
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:
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:
1164728689
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/11/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1027 FRENCH RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
INDIANOLA
Provider Business Mailing Address State Name:
MS
Provider Business Mailing Address Postal Code:
38751-9605
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
662-466-0330
Provider Business Mailing Address Fax Number:
662-756-0931

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
108 N RUBY AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RULEVILLE
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
38771-3940
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
662-756-2072
Provider Business Practice Location Address Fax Number:
662-756-2074
Provider Enumeration Date:
01/31/2011

Additional Information

Authorized Official

Authorized Official Last Name:
STEELE
Authorized Official First Name:
TINA
Authorized Official Middle Name:
L.
Authorized Official Title or Position:
ADMINISTRATOR/DIRECTOR
Authorized Official Telephone Number:
662-466-0330

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)





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