MEDICARE: HOSPICE FAMILY CARE, INC.

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	HSPC0062	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	AZ0700420	OTHER	AZ	BC/BS OF ARIZONA

General Provider Information

NPI Number	:	1104802545
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOSPICE FAMILY CARE, INC.

Provider Business Mailing Address
First Line	:	17220 N BOSWELL BLVD
Second Line	:	SUITE E225
City	:	SUN CITY
State	:	AZ
Zip	:	85373-1982
Country	:	US
Telephone Number	:	623-876-9100
Fax Number	:	623-876-9300

Provider Business Practice Location Address
First Line	:	17220 N BOSWELL BLVD
Second Line	:	SUITE E225
City	:	SUN CITY
State	:	AZ
Zip	:	85373-1982
Country	:	US
Telephone Number	:	623-876-9100
Fax Number	:	623-876-9300

Authorized Official
Title or Position	:	REGIONA QA COORDINATOR
Name	:	MRS. GAIL CYNTHIA HILDITCH
Credential	:	RN
Telephone Number	:	623-876-9100

Provider Enumeration Date	:	12/19/2005
Last Update Date	:	08/22/2020

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