SOUTHERNCARE INC. NPI 1396784732

NPI Information

NPI: 1396784732
Provider Name: SOUTHERNCARE, INC.

Doing Business As: SOUTHERNCARE LUCEDALE

Classification: Hospice Care, Community Based - 251G00000X
Entity Type: Organization
Address:
98 GLEN OAKS DR
LUCEDALE, MS
ZIP 39452
Phone: (662) 578-4072
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SOUTHERNCARE, INC. is a hospice care community based in Lucedale, MS. SOUTHERNCARE, INC. NPI is 1396784732. The provider is registered as an organization entity type.
The provider Is Doing Business As Southerncare Lucedale.

The provider's business location address is:

98 GLEN OAKS DR
LUCEDALE, MS
ZIP 39452-857
Phone: (662) 578-4072
Fax: (662) 578-7956

The provider's authorized official is Jessica Kleberg .
The authorized official title is Vp Of Legal Affairs and has the following contact phone number (704) 664-2876.

The enumeration date for this NPI number is 6/4/2006 and was last updated on 5/16/2016.

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			MISSISSIPPI	No
2	251G00000X	Hospice Care, Community Based		039	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
1	00770379	MEDICAID	MISSISSIPPI
2	25-1537	MEDICARE PIN	MISSISSIPPI
3	251537	MEDICARE OSCAR/CERTIFICATION

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: 5/5/2024

NPI Synchronization or Removal

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