MEDICARE: HEARTHSTONE HOSPITAL MESA

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	282E00000X	Long Term Care Hospital	SH 4388	AZ
2	314000000X	Skilled Nursing Facility	NCI 386	AZ
3	314000000X	Skilled Nursing Facility	SH 4388	AZ

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	03-2007	OTHER	AZ	MEDICARE

Other Identifiers

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

General Provider Information

NPI Number	:	1245228170
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEARTHSTONE HOSPITAL MESA

Provider Business Mailing Address
First Line	:	215 S POWER RD
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85206-5235
Country	:	US
Telephone Number	:	480-985-6992
Fax Number	:	480-981-8390

Provider Business Practice Location Address
First Line	:	215 S POWER RD
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85206-5235
Country	:	US
Telephone Number	:	480-985-6992
Fax Number	:	480-981-8390

Authorized Official
Title or Position	:	DIRECTOR OF FINANCIAL SERVICES
Name	:	MRS. BARBARA ANN MAHER
Credential	:
Telephone Number	:	480-329-2877

Provider Enumeration Date	:	10/13/2005
Last Update Date	:	01/22/2009

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Directions to “HEARTHSTONE HOSPITAL MESA ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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