Miracle Care Hospice, Inc.

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

087 Issued in MS

Legal business name

MIRACLE CARE HOSPICE, INC.

Practice address

330 Edgewood Terrace Dr
Suite B
Jackson, MS 39206-6216

Phone

(601) 982-1909

Fax

(601) 982-8177

NPI assigned

Jan 24, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Eddie Lee Jr.

Title

Ceo

Phone

(601) 982-1909

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1871648758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 EDGEWOOD TERRACE DR",
            "address_2": "SUITE B",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392066216",
            "telephone_number": "601-982-1909",
            "fax_number": "601-982-8177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 EDGEWOOD TERRACE DR",
            "address_2": "SUITE B",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392066216",
            "telephone_number": "601-982-1909",
            "fax_number": "601-982-8177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRACLE CARE HOSPICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "EDDIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "601-982-1909",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "MS",
            "license": "087",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07588281",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Melissa N Minor, PA-C
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• Roger Victor Mishoe, BS
• Noella Misquita, MD
• Miss Reproductive Medicine PLLC

• Community Based Hospice Care Agency in Jackson, MS
• Providers in Jackson, 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 Aug 22, 2020; 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.