Provider Demographics
NPI:1588685614
Name:NORTH MISSISSIPPI HOSPICE OF OXFORD
Entity Type:Organization
Organization Name:NORTH MISSISSIPPI HOSPICE OF OXFORD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:S
Authorized Official - Last Name:MCCAY
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN, MBA
Authorized Official - Phone:662-234-0140
Mailing Address - Street 1:104 SKYLINE DR
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MS
Mailing Address - Zip Code:38655-9781
Mailing Address - Country:US
Mailing Address - Phone:662-234-0140
Mailing Address - Fax:662-234-0176
Practice Address - Street 1:104 SKYLINE DR
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655-9781
Practice Address - Country:US
Practice Address - Phone:662-234-0140
Practice Address - Fax:662-234-0176
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS084251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00930305Medicaid
MS00930305Medicaid