Provider Demographics
NPI:1568618288
Name:JACQUELINE MAGEE
Entity Type:Organization
Organization Name:JACQUELINE MAGEE
Other - Org Name:COMPREHENSIVE HOSPICE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:YVETTE
Authorized Official - Last Name:MAGEE
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:662-890-6939
Mailing Address - Street 1:8880 GERMANTOWN RD STE 502
Mailing Address - Street 2:
Mailing Address - City:OLIVE BRANCH
Mailing Address - State:MS
Mailing Address - Zip Code:38654-8561
Mailing Address - Country:US
Mailing Address - Phone:662-890-6939
Mailing Address - Fax:
Practice Address - Street 1:8880 GERMANTOWN RD STE 502
Practice Address - Street 2:
Practice Address - City:OLIVE BRANCH
Practice Address - State:MS
Practice Address - Zip Code:38654-8561
Practice Address - Country:US
Practice Address - Phone:662-890-6939
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-13
Last Update Date:2008-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS166251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS06371306Medicaid