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General NPI Number Information
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NPI Number | 1609944669
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Entity Type | Organization
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Legal Business Name | PREMIER HOSPICE AND PALLIATIVE CARE, LLC
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Dates
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Enumeration Date | 11/30/2006
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Last Update Date | 01/17/2018
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Provider Practice Location Address
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Address Line | 3550 N CENTRAL AVE STE 1200
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City | PHOENIX
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State | AZ
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Zip | 85012-2111
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Country | US
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Telephone | 602-274-7572
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Fax | 602-274-5465
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Provider Business Mailing Address
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Address Line | 3550 N CENTRAL AVE STE 1200
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City | PHOENIX
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State | AZ
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Zip | 85012-2111
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Country | US
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Telephone | 602-274-7572
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Fax | 602-274-5465
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Authorized Official
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Title or Position | CFO
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Name | DAVID KOSLOFF
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Credential |
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Telephone | 206-576-0087
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | HSPC4076
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License Number State | AZ
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