MEDICARE: AKDHC, 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	207RN0300X	Nephrology Physician		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	:	1396231445
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AKDHC, LLC

Provider Business Mailing Address
First Line	:	3333 E CAMELBACK RD STE 180
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85018-2396
Country	:	US
Telephone Number	:	602-759-6883
Fax Number	:	602-224-3358

Provider Business Practice Location Address
First Line	:	5750 W THUNDERBIRD RD STE F680
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85306-4693
Country	:	US
Telephone Number	:	602-843-7171
Fax Number	:	602-843-5909

Authorized Official
Title or Position	:	DIRECTOR OF PHYSICIAN SERVICES
Name	:	MS. KRISTEN KLEIN
Credential	:
Telephone Number	:	602-997-0484

Provider Enumeration Date	:	07/02/2018
Last Update Date	:	11/27/2024

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