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MISSISSIPPI HOMECARE LLC NPI 1497867857


NPI Information

NPI: 1497867857
Provider Name: MISSISSIPPI HOMECARE, LLC
Classification: Home Health - 251E00000X
Entity Type: Organization
Address:
2080 S FRONTAGE RD STE 107
VICKSBURG, MS
ZIP 39180
Phone: (601) 629-0015
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MISSISSIPPI HOMECARE, LLC is a home health in Vicksburg, MS. The provider is a public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. MISSISSIPPI HOMECARE, LLC NPI is 1497867857. The provider is registered as an organization entity type.

The provider's business location address is:

2080 S FRONTAGE RD STE 107
VICKSBURG, MS
ZIP 39180-882
Phone: (601) 629-0015
Fax: (601) 629-0046

The provider's authorized official is Donald D. Stelly .
The authorized official title is President and has the following contact phone number (337) 233-1307.

The enumeration date for this NPI number is 8/31/2006 and was last updated on 3/9/2018.


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
1251E00000XHome Health3581MISSISSIPPIYes

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
10770602MEDICAIDMISSISSIPPI
270757OTHERMISSISSIPPIBLUE CROSS BLUE SHIELD OF

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

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