MEDICARE: YRMC HOSPICE

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	HSPC0008	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

General Provider Information

NPI Number	:	1467409219
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YRMC HOSPICE

Provider Business Mailing Address
First Line	:	3262 N WINDSONG DR
Second Line	:
City	:	PRESCOTT VALLEY
State	:	AZ
Zip	:	86314-2255
Country	:	US
Telephone Number	:	928-759-5900
Fax Number	:	928-759-5982

Provider Business Practice Location Address
First Line	:	3262 N WINDSONG DR
Second Line	:
City	:	PRESCOTT VALLEY
State	:	AZ
Zip	:	86314-2255
Country	:	US
Telephone Number	:	928-759-5900
Fax Number	:	928-759-5982

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	MR. DOUGLAS O BRISTOL
Credential	:
Telephone Number	:	928-771-5691

Provider Enumeration Date	:	05/27/2006
Last Update Date	:	08/22/2020

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Directions to “YRMC HOSPICE ” Practice Location

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