Healthcare Provider Details

I. General information

NPI: 1073328563
Provider Name (Legal Business Name): ARIZONA PALLIATIVE CARE PRESCOTT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2025
Last Update Date: 02/11/2025
Certification Date: 02/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12035 N SAGUARO BLVD STE 202
FOUNTAIN HILLS AZ
85268-4647
US

IV. Provider business mailing address

12035 N SAGUARO BLVD STE 202
FOUNTAIN HILLS AZ
85268-4647
US

V. Phone/Fax

Practice location:
  • Phone: 480-588-8200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: CLADIO CALFA
Title or Position: MEMBER
Credential:
Phone: 480-588-8200