1932270972 NPI number — WORD OF DELIVERANCE 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 1932270972 NPI number — WORD OF DELIVERANCE HOSPICE INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WORD OF DELIVERANCE 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:
1932270972
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/13/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
216 N CHRISMAN AVE
Provider Second Line Business Mailing Address:
P.O.BOX 239
Provider Business Mailing Address City Name:
CLEVELAND
Provider Business Mailing Address State Name:
MS
Provider Business Mailing Address Postal Code:
38732-2730
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
662-843-8797
Provider Business Mailing Address Fax Number:
662-843-8772

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
216 N CHRISMAN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLEVELAND
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
38732-2730
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
662-843-8797
Provider Business Practice Location Address Fax Number:
662-843-8772
Provider Enumeration Date:
11/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
LAWTON
Authorized Official First Name:
GLORIA
Authorized Official Middle Name:
M
Authorized Official Title or Position:
ADMINSTRATOR CEO
Authorized Official Telephone Number:
662-719-7800

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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