Provider Demographics
NPI:1235117391
Name:GILBERT'S HOSPICE CARE OF MISSISSIPPI, LLC
Entity Type:Organization
Organization Name:GILBERT'S HOSPICE CARE OF MISSISSIPPI, LLC
Other - Org Name:GENTIVA HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSISTANT SECRETARY
Authorized Official - Prefix:MS
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:C
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-814-2288
Mailing Address - Street 1:12900 FOSTER ST STE 400
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66213-2696
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:376 SIMPSON HWY 149
Practice Address - Street 2:SUITE 300
Practice Address - City:MAGEE
Practice Address - State:MS
Practice Address - Zip Code:39111-3569
Practice Address - Country:US
Practice Address - Phone:601-849-5803
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-08
Last Update Date:2014-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS03538248Medicaid
251593Medicare Oscar/Certification