Organization
PROVIDENCE HOSPICE SOUTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHELLE E MEEKS RN (ADMINISTRATOR)
(601) 705-0360
Entity
Organization
Contact information
Practice address
811 REBECCA AVE, HATTIESBURG, MS 39401
(601) 705-0360
(601) 705-0365
Mailing address
811 REBECCA AVE, PROVIDENCE HOSPICE SOUTH, HATTIESBURG, MS 39401
(601) 705-0360
(601) 705-0365
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
138
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08158561
—
MS
Enumeration date
05/04/2006
Last updated
04/04/2011
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