Healthcare Provider Details

I. General information

NPI: 1104650662
Provider Name (Legal Business Name): DUNAMIS HOME HEALTHCARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2024
Last Update Date: 08/28/2024
Certification Date: 08/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44927 W HATHAWAY AVE
MARICOPA AZ
85139
US

IV. Provider business mailing address

PO BOX 804
MARICOPA AZ
85139-0297
US

V. Phone/Fax

Practice location:
  • Phone: 928-923-6036
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: NANCY ERMERT
Title or Position: OWNER, PRESIDENT
Credential:
Phone: 928-923-6036