Organization
ETERNITY HOSPICE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONALD PUGH SR. (VICE PRESIDENT)
(601) 517-0025
Entity
Organization
Contact information
Practice address
337 ELLISVILLE BLVD, LAUREL, MS 39440-4523
(601) 649-4105
(601) 649-4045
Mailing address
337 ELLISVILLE BLVD, LAUREL, MS 39440-4523
(601) 649-4105
(601) 649-4045
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
127
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00386341
—
MS
Enumeration date
05/31/2006
Last updated
11/13/2007
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