Provider Demographics
NPI:1407296890
Name:ST. LUKE HOME HEALTH SERVICES, LLC
Entity Type:Organization
Organization Name:ST. LUKE HOME HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NORMAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-249-1808
Mailing Address - Street 1:PO BOX 1103
Mailing Address - Street 2:
Mailing Address - City:MCCOMB
Mailing Address - State:MS
Mailing Address - Zip Code:39649-1103
Mailing Address - Country:US
Mailing Address - Phone:888-249-4270
Mailing Address - Fax:601-249-4292
Practice Address - Street 1:271 F E SELLERS HWY
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:MS
Practice Address - Zip Code:39654-9556
Practice Address - Country:US
Practice Address - Phone:888-249-4270
Practice Address - Fax:601-587-1154
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-28
Last Update Date:2017-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based