MEDICARE: GOLDEN HOSPICE CARE INC

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	251G00000X	Community Based Hospice Care Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	HSPC13276	OTHER	AZ	AZDHS LICENSE

General Provider Information

NPI Number	:	1053066829
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOLDEN HOSPICE CARE INC

Provider Business Mailing Address
First Line	:	4150 W PEORIA AVE STE B113J
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85029-3900
Country	:	US
Telephone Number	:	747-877-2925
Fax Number	:

Provider Business Practice Location Address
First Line	:	4150 W PEORIA AVE STE B113J
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85029-3900
Country	:	US
Telephone Number	:	747-877-2925
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	TAMARA HOVHANNISYAN
Credential	:
Telephone Number	:	747-877-2925

Provider Enumeration Date	:	02/19/2022
Last Update Date	:	05/12/2026

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Directions to “GOLDEN HOSPICE CARE INC ” Practice Location

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