Provider Demographics
NPI:1497873194
Name:ONCALL OF MISSISSIPPI
Entity Type:Organization
Organization Name:ONCALL OF MISSISSIPPI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN ADMINSTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:
Authorized Official - Last Name:HOFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:228-831-1510
Mailing Address - Street 1:16197B LANDON RD
Mailing Address - Street 2:
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39503-4121
Mailing Address - Country:US
Mailing Address - Phone:228-831-1510
Mailing Address - Fax:
Practice Address - Street 1:16197B LANDON RD
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39503-4121
Practice Address - Country:US
Practice Address - Phone:228-831-1510
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS2536251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00628293Medicaid