Organization
GENESIS HOSPICE CARE
Active
Organization
GENESIS HOSPICE CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHARLINE BRANDON RN (ADMINISTRATOR)
(662) 846-0922
Entity
Organization
Contact information
Practice address
201 W SUNFLOWER RD, POB 1888, CLEVELAND, MS 38732-2637
(662) 846-0922
(662) 846-0833
Mailing address
201 W SUNFLOWER RD, POB 1888, CLEVELAND, MS 38732-2637
(662) 846-0922
(662) 846-0833
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00770306
—
MS
01
—
4070046
BLUE CROSS BLUE SHIELD
MS
Enumeration date
09/25/2006
Last updated
08/22/2020
Update your record
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