MEDICARE: TRANQUILITY 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	4249	OK

General Provider Information

NPI Number	:	1164584280
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRANQUILITY HOSPICE LLC

Provider Business Mailing Address
First Line	:	1815 E 15TH ST
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74104-4610
Country	:	US
Telephone Number	:	918-809-6205
Fax Number	:

Provider Business Practice Location Address
First Line	:	1815 E 15TH ST
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74104-4610
Country	:	US
Telephone Number	:	918-809-6205
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	FARSHID ADAM-AMIR ZANDI
Credential	:	MD
Telephone Number	:	918-809-6205

Provider Enumeration Date	:	12/14/2006
Last Update Date	:	01/31/2008

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Directions to “TRANQUILITY HOSPICE LLC ” Practice Location

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