Healthcare Provider Details

I. General information

NPI: 1154752343
Provider Name (Legal Business Name): A.M.I. HOMECARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2013
Last Update Date: 12/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20650 N 29TH PL STE 105
PHOENIX AZ
85050-4782
US

IV. Provider business mailing address

206540 N. 29TH PL STE 105
PHOENIX AZ
85050-4783
US

V. Phone/Fax

Practice location:
  • Phone: 602-788-3400
  • Fax: 602-788-3405
Mailing address:
  • Phone: 602-788-3400
  • Fax: 602-788-3405

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: ANTHONY SAMMARTINO
Title or Position: OWNER/MANAGER
Credential: RPH
Phone: 602-788-3400