MEDICARE: SIMCHAH CARE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	376K00000X	Nurse's Aide
2	376J00000X	Homemaker

General Provider Information

NPI Number	:	1093977092
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SIMCHAH CARE, LLC

Provider Business Mailing Address
First Line	:	8601 N BLACK CANYON HWY
Second Line	:	SUITE 208
City	:	PHOENIX
State	:	AZ
Zip	:	85021-4109
Country	:	US
Telephone Number	:	602-595-1539
Fax Number	:	602-513-7216

Provider Business Practice Location Address
First Line	:	8601 N BLACK CANYON HWY
Second Line	:	SUITE 208
City	:	PHOENIX
State	:	AZ
Zip	:	85021-4109
Country	:	US
Telephone Number	:	602-595-1539
Fax Number	:	602-513-7216

Authorized Official
Title or Position	:	OWNER
Name	:	AMY L FARLEY
Credential	:
Telephone Number	:	602-595-1539

Provider Enumeration Date	:	06/30/2008
Last Update Date	:	06/30/2008

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