Organization
MENA MEDICAL CENTER HOSPICE, LLC
Active
Other names
Elite Hospice
Organization subpart
No
Provider details
NPI number
Authorized official
JOSHUA L PROFFITT (PRESIDENT)
(337) 233-1307
Entity
Organization
Contact information
Practice address
602 DEQUEEN ST, MENA, AR 71953-3218
(479) 394-1134
(479) 394-2056
Mailing address
PO BOX 51266, LAFAYETTE, LA 70505-1266
(337) 233-1307
(337) 233-5764
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
AR4411
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11559
ARKANSAS BLUE CROSS BLUE
AR
05
—
159675747
—
AR
Enumeration date
10/24/2006
Last updated
02/13/2024
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