1891764890 NPI number — UNITY HOSPICE CARE, LLC

Table of content: (NPI 1891764890)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891764890 NPI number — UNITY HOSPICE CARE, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNITY HOSPICE CARE, LLC
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:
1891764890
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/22/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1125 SCHILLING BLVD E STE 101
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COLLIERVILLE
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
38017-7078
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
901-756-7322
Provider Business Mailing Address Fax Number:
901-756-7085

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9035 E SANDIDGE RD STE 102
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OLIVE BRANCH
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
38654-3563
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
662-893-5662
Provider Business Practice Location Address Fax Number:
662-893-5664
Provider Enumeration Date:
03/14/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
PERKINS
Authorized Official First Name:
KRISTAN
Authorized Official Middle Name:
Authorized Official Title or Position:
COO
Authorized Official Telephone Number:
901-756-7322

Provider Taxonomy Codes

  • Taxonomy code: 251G00000X , with the licence number:  68 , 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: 00770532 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000070129 . This is a "BCBS" identifier , issued by the state of ( MS ) . This identifiers is of the category "OTHER".