Healthcare Provider Details

I. General information

NPI: 1619889128
Provider Name (Legal Business Name): TERRAMEDICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 S ARCADIA WAY
CHANDLER AZ
85248-4116
US

IV. Provider business mailing address

3800 S ARCADIA WAY
CHANDLER AZ
85248-4116
US

V. Phone/Fax

Practice location:
  • Phone: 480-786-9671
  • Fax:
Mailing address:
  • Phone: 480-786-9671
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code374K00000X
TaxonomyReligious Nonmedical Practitioner
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: SAM HAYDAR
Title or Position: PRESIDENT
Credential: MD
Phone: 480-786-9671