Provider Demographics
NPI:1477935013
Name:SOUTH MISSISSIPPI HOME HEALTH, INC.
Entity Type:Organization
Organization Name:SOUTH MISSISSIPPI HOME HEALTH, INC.
Other - Org Name:DEACONESS HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARY / TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:GACHASSIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-233-1307
Mailing Address - Street 1:PO BOX 51266
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70505-1266
Mailing Address - Country:US
Mailing Address - Phone:337-233-1307
Mailing Address - Fax:337-233-5764
Practice Address - Street 1:1641A POPPS FERRY ROAD
Practice Address - Street 2:SUITE A-5
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39532-2249
Practice Address - Country:US
Practice Address - Phone:228-435-2265
Practice Address - Fax:228-435-3379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS251696Medicare Oscar/Certification