Healthcare Provider Details

I. General information

NPI: 1689902520
Provider Name (Legal Business Name): HOME HEALTH SPECIALISTS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2009
Last Update Date: 12/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5355 E HIGH ST UNIT 221
PHOENIX AZ
85054-5445
US

IV. Provider business mailing address

5355 E HIGH ST UNIT 221
PHOENIX AZ
85054-5445
US

V. Phone/Fax

Practice location:
  • Phone: 480-381-0054
  • Fax:
Mailing address:
  • Phone: 480-381-0054
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ELLIOTT D FRUTKIN
Title or Position: PRESIDENT
Credential: PRESIDENT
Phone: 480-381-0054