LIFE SOURCE SERVICES LLC NPI 1295793982

NPI Information

  • NPI: 1295793982
  • Provider Name: LIFE SOURCE SERVICES, LLC
  • Classification: Hospice Care, Community Based - 251G00000X
  • Entity Type: Organization
  • Doing Business As: PAX HOSPICE (GREENWOOD)
  • Address: 115 FULTON ST
    GREENWOOD, MS
    ZIP 38930
  • Phone: (662) 451-9912

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NPI Details

LIFE SOURCE SERVICES, LLC is a hospice care community based in Greenwood, MS. LIFE SOURCE SERVICES, LLC NPI is 1295793982. The provider is registered as an organization entity type.
The provider Is Doing Business As Pax Hospice (greenwood).

The provider's business location address is:

115 FULTON ST
GREENWOOD, MS
ZIP 38930-361
Phone: (662) 451-9912
Fax: (662) 451-9915

The provider's authorized official is Randy Belton .
The authorized official title is Authorized Representative and has the following contact phone number (601) 709-1408.

The enumeration date for this NPI number is 5/2/2006 and was last updated on 8/22/2020.

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
1251G00000XHospice Care, Community Based126MISSISSIPPIYes

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
103332314MEDICAIDMISSISSIPPI

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: 11/21/2025

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