MEDICARE: DYNA CARE ARIZONA LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	HHA3390	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043375686
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DYNA CARE ARIZONA LLC

Provider Business Mailing Address
First Line	:	1201 S ALMA SCHOOL RD
Second Line	:	SUITE 7550
City	:	MESA
State	:	AZ
Zip	:	85210-2008
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5800 W GLENN DR
Second Line	:	SUITE 320
City	:	GLENDALE
State	:	AZ
Zip	:	85301-2468
Country	:	US
Telephone Number	:	623-847-9900
Fax Number	:	623-847-1188

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. ABITURAB BOXWALLA
Credential	:
Telephone Number	:	708-560-2925

Provider Enumeration Date	:	12/26/2006
Last Update Date	:	08/22/2020

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Directions to “DYNA CARE ARIZONA LLC ” Practice Location

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