Organization
ST. JUDE HOSPICE MISSISSIPPI, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS J MORELAND (CEO)
(515) 221-9155
Entity
Organization
Contact information
Practice address
3166 W JACKSON ST, SUITE # 2, TUPELO, MS 38801-7154
(662) 841-5907
(662) 841-5910
Mailing address
13375 UNIVERSITY AVE, SUITE 200, CLIVE, IA 50325-8261
(515) 221-9155
(515) 221-9157
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
094
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03504070
—
MS
Enumeration date
10/16/2006
Last updated
08/24/2010
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