Healthcare Provider Details

I. General information

NPI: 1043690381
Provider Name (Legal Business Name): QUALITY PALLIATIVE CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2015
Last Update Date: 06/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1112 E WASHINGTON ST
PHOENIX AZ
85034-1010
US

IV. Provider business mailing address

1112 E WASHINGTON ST
PHOENIX AZ
85034-1010
US

V. Phone/Fax

Practice location:
  • Phone: 602-621-4999
  • Fax:
Mailing address:
  • Phone: 602-621-4995
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License NumberUNC7051
License Number StateAZ

VIII. Authorized Official

Name: MR. CLIDE CALFA
Title or Position: OWNER
Credential:
Phone: 602-266-2203