Organization Name: | ST. JOHN HOSPICE |
NPI Number: | 1275766990 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | AMANDA JENKINS (OWNER) |
Mailing Address: | 2201 Highway 49 Ste B Wiggins |
State: | MS US |
Postal Code: | 395778013 |
Phone Number: | 6016060103 |
Fax Number: | |
NPI Enumeration Date: | 08/27/2009 |
NPI Last Update Date: | 08/27/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 251G00000X |
License Number: | 000000 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MS |
Taxonomy Type: | Agencies |
Taxonomy Classification: | Hospice Care, Community Based |
Taxonomy Specialization: | |
Taxonomy Definition: |