MEDICARE: ARIZONA PROFESSIONAL HEALTHCARE 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

General Provider Information

NPI Number	:	1962134833
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARIZONA PROFESSIONAL HEALTHCARE LLC

Provider Business Mailing Address
First Line	:	11225 N 28TH DR STE A208
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85029-5631
Country	:	US
Telephone Number	:	602-490-8841
Fax Number	:	602-459-9851

Provider Business Practice Location Address
First Line	:	11225 N 28TH DR STE A208
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85029-5631
Country	:	US
Telephone Number	:	602-490-8841
Fax Number	:	602-459-9851

Authorized Official
Title or Position	:	ADMINISTRATOR/OWNER
Name	:	STEPHEN TAN
Credential	:
Telephone Number	:	602-490-8841

Provider Enumeration Date	:	06/28/2022
Last Update Date	:	07/10/2023

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