Eternity Hospice Inc

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

093 Issued in MS

Legal business name

ETERNITY HOSPICE INC

Practice address

417 Highway 82 E Ste 23
Indianola, MS 38751-2315

Phone

(662) 887-3380

Fax

(662) 887-3739

NPI assigned

Jun 22, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Charles L Fairley

Title

President

Phone

(601) 517-0025

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194912000000",
    "number": "1730125949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 686",
            "city": "INDIANOLA",
            "state": "MS",
            "postal_code": "387510686",
            "telephone_number": "662-887-3380",
            "fax_number": "662-887-3739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 HIGHWAY 82 E STE 23",
            "city": "INDIANOLA",
            "state": "MS",
            "postal_code": "387512315",
            "telephone_number": "662-887-3380",
            "fax_number": "662-887-3739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ETERNITY HOSPICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-22",
        "last_updated": "2007-11-13",
        "status": "A",
        "authorized_official_last_name": "FAIRLEY",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "601-517-0025"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "MS",
            "license": "093",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09628359",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura Elizabeth Turner Downs, FNP-C
• Arteya McGuire Drain, RMA/WELLNESS COACH
• David Keith Dunigan, M.D.
• Dynamic Indianola Operating LLC (Indianola Health & Rehabilitation Center)
• Elise's Place Adc
• Family Dental Care
• Fast Pace Mississippi, PLLC
• Fit4Me Adult Day Care
• Deedra Brackeen Fontana, RPH
• Genesis Hospice Care

• Community Based Hospice Care Agency in Indianola, MS
• Providers in Indianola, MS by specialty
• Community Based Hospice Care Agency in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.