Healthcare Provider Details

I. General information

NPI: 1457381295
Provider Name (Legal Business Name): RTA HOSPICE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 03/07/2022
Certification Date: 03/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7000 STATE ROUTE 179 STE D100
SEDONA AZ
86351-9273
US

IV. Provider business mailing address

10 CADILLAC DR SUITE 400
BRENTWOOD TN
37027-5078
US

V. Phone/Fax

Practice location:
  • Phone: 928-284-0180
  • Fax: 928-284-9352
Mailing address:
  • Phone: 615-425-5407
  • Fax: 615-373-4457

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code315D00000X
TaxonomyInpatient Hospice
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: RUSSELL ADKINS
Title or Position: SVP GENERAL COUNSEL
Credential:
Phone: 615-309-5668