Healthcare Provider Details

I. General information

NPI: 1699104307
Provider Name (Legal Business Name): SOUTHWESTERN PALLIATIVE CARE ASSOCIATES PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2013
Last Update Date: 03/09/2020
Certification Date: 03/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1950 W 3RD ST
YUMA AZ
85364-1812
US

IV. Provider business mailing address

1950 W 3RD ST
YUMA AZ
85364-1812
US

V. Phone/Fax

Practice location:
  • Phone: 928-276-4477
  • Fax: 928-276-4481
Mailing address:
  • Phone: 928-276-4477
  • Fax: 928-276-4481

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: FRANCES EILEEN DAVISON
Title or Position: OWNER/MANAGER
Credential: FNP-BC
Phone: 928-246-5137