1376588939 NPI number — HEART TO HEART HOSPICE, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376588939 NPI number — HEART TO HEART HOSPICE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEART TO HEART HOSPICE, 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:
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:
1376588939
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 875
Provider Second Line Business Mailing Address:
278 HWY. 366 EAST
Provider Business Mailing Address City Name:
BELMONT
Provider Business Mailing Address State Name:
MS
Provider Business Mailing Address Postal Code:
38827-0875
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
662-454-3632
Provider Business Mailing Address Fax Number:
662-454-0281

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
278 HIGHWAY 366
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BELMONT
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
38827-7751
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
662-454-3632
Provider Business Practice Location Address Fax Number:
662-454-0281
Provider Enumeration Date:
06/18/2006

Additional Information

Authorized Official

Authorized Official Last Name:
HICKS
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
901-854-6185

Provider Taxonomy Codes

  • Taxonomy code: 251G00000X , with the licence number:  065 , registered in the state of MS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 00770496 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com