Life Source Services, Llc

NPI 1295793982 - Hospice Care, Community Based - 251G00000X

NPI Details
NPI 1295793982
Enumeration Date 05/02/2006
Last Updated 07/09/2007
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name RANDY RANDY
Position AUTHORIZED REPRESENTATIVE
Phone (662) 451-9912
Fax (662) 451-9915
Practice Location
115 FULTON ST
GREENWOOD MS, 38930-4361, US
Phone (662) 451-9912
Fax (662) 451-9915
Business Location
115 FULTON ST
GREENWOOD MS, 38930-4361, US
Phone (662) 451-9912
Fax (662) 451-9915
Toxanomy
Taxonomy Code 251G00000X
License State Mississippi
License Number 126
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According to our database, Life Source Services, Llc NPI is 1295793982, taxonomy code is 251G00000X and license number is 126, license state is located at Mississippi. Life Source Services, Llc physically located at 115 Fulton St, Greenwood MS, 38930-4361. NPI Number 1033115704 has the healthcare provider type.

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1295793982 NPI number is provided on an as is basis without warranty of any kind. 1295793982 is maintained by the National Plan & Provider Enumeration System. The contents of Life Source Services, Llc are for informational purposes only.