MEDICARE: JOSEPHINA ANGHEAR THEIL SR.

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	EM4683	AZ

General Provider Information

NPI Number	:	1487376851
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPHINA ANGHEAR THEIL SR.

Provider Business Mailing Address
First Line	:	12521 W CORRINE DR
Second Line	:
City	:	EL MIRAGE
State	:	AZ
Zip	:	85335-6213
Country	:	US
Telephone Number	:	480-652-0718
Fax Number	:

Provider Business Practice Location Address
First Line	:	12521 W CORRINE DR
Second Line	:
City	:	EL MIRAGE
State	:	AZ
Zip	:	85335-6213
Country	:	US
Telephone Number	:	480-652-0718
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/13/2022
Last Update Date	:	05/27/2026

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