Organization
ETERNITY HOSPICE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES FAIRLEY (PRESIDENT)
(601) 517-0025
Entity
Organization
Contact information
Practice address
12000 MOBILE AVE, GULFPORT, MS 39503-3113
(228) 832-7211
(228) 832-7213
Mailing address
12000 MOBILE AVE, GULFPORT, MS 39503-3113
(228) 832-7211
(228) 832-7213
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
251617
MS
Other
Enumeration date
07/03/2006
Last updated
03/26/2009
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