MEDICARE: FIRST CHOICE HOSPICE 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	251G00000X	Community Based Hospice Care Agency

General Provider Information

NPI Number	:	1104434141
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FIRST CHOICE HOSPICE LLC

Provider Business Mailing Address
First Line	:	1738 E THOMAS RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85016-7604
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1738 E THOMAS RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85016-7604
Country	:	US
Telephone Number	:	602-842-2485
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	HAYK VARDANYAN
Credential	:
Telephone Number	:	602-842-2485

Provider Enumeration Date	:	07/15/2020
Last Update Date	:	07/15/2020

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Directions to “FIRST CHOICE HOSPICE LLC ” Practice Location

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