MEDICARE: ACCESS AZ HOSPICE & PALLIATIVE CARE, 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	251G00000X	Community Based Hospice Care Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1093334880	OTHER	AZ	HOSPICE (08)

General Provider Information

NPI Number	:	1851000624
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACCESS AZ HOSPICE & PALLIATIVE CARE, LLC

Provider Business Mailing Address
First Line	:	14362 N FRANK LLOYD WRIGHT BLVD STE 1101
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85260-8846
Country	:	US
Telephone Number	:	602-884-9733
Fax Number	:

Provider Business Practice Location Address
First Line	:	14362 N FRANK LLOYD WRIGHT BLVD STE 1101
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85260-8846
Country	:	US
Telephone Number	:	602-884-9733
Fax Number	:	520-448-4860

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	SHELLYDALE PRINCESS GRAY
Credential	:
Telephone Number	:	310-357-0398

Provider Enumeration Date	:	11/21/2022
Last Update Date	:	11/21/2022

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Directions to “ACCESS AZ HOSPICE & PALLIATIVE CARE, LLC ” Practice Location

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