MEDICARE: A-1 PHOENIX HEALTHCARE 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	251E00000X	Home Health Agency
2	251E00000X	Home Health Agency		TX

General Provider Information

NPI Number	:	1114255619
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A-1 PHOENIX HEALTHCARE LLC

Provider Business Mailing Address
First Line	:	1304 W WALNUT HILL LN STE 380
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75038-2942
Country	:	US
Telephone Number	:	214-591-0110
Fax Number	:	214-591-0106

Provider Business Practice Location Address
First Line	:	1304 W WALNUT HILL LN STE 380
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75038-2942
Country	:	US
Telephone Number	:	214-591-0110
Fax Number	:	214-591-0106

Authorized Official
Title or Position	:	CEO
Name	:	JUSTIN DUMAGPI
Credential	:
Telephone Number	:	214-591-0110

Provider Enumeration Date	:	11/23/2009
Last Update Date	:	02/28/2025

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