SANCTUARY HOSPICE HOUSE INC NPI 1659392645

NPI Information

NPI: 1659392645
Provider Name: SANCTUARY HOSPICE HOUSE, INC
Classification: Hospice Care, Community Based - 251G00000X
Entity Type: Organization

CLIA Number: 25D1047452

Address:
5159 W MAIN ST
TUPELO, MS
ZIP 38801
Phone: (662) 844-2111
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SANCTUARY HOSPICE HOUSE, INC is a hospice care community based in Tupelo, MS. SANCTUARY HOSPICE HOUSE, INC NPI is 1659392645. The provider is registered as an organization entity type.

The provider's business location address is:

5159 W MAIN ST
TUPELO, MS
ZIP 38801-200
Phone: (662) 844-2111
Fax: (662) 844-2354

The provider's authorized official is George Hand .
The authorized official title is Administrator and has the following contact phone number (662) 844-2111.

The CLIA number assigned to this NPI record is 25D1047452 - hospice with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/22/2006 and was last updated on 4/28/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	251G00000X	Hospice Care, Community Based		136	MISSISSIPPI	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	251623	MEDICARE ID-TYPE UNSPECIFIED	MISSISSIPPI	MEDICARE
2	02904881	MEDICAID	MISSISSIPPI
3	000070104	OTHER	MISSISSIPPI	BLUE CROSS BLUE SHIELD

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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