Healthcare Provider Details

I. General information

NPI: 1407790470
Provider Name (Legal Business Name): COTSWOLD PYTHON ENTERPRISES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2026
Last Update Date: 04/17/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3122 E CLAREMONT AVE
PHOENIX AZ
85016-2358
US

IV. Provider business mailing address

3122 E CLAREMONT AVE
PHOENIX AZ
85016-2358
US

V. Phone/Fax

Practice location:
  • Phone: 573-268-7848
  • Fax:
Mailing address:
  • Phone: 573-268-7848
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: PHILIP WALSH
Title or Position: OWNER
Credential:
Phone: 573-268-7848