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	HSPC0044	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	F13790	OTHER	AZ	PHOENIX HEALTH PLAN
3	IZ0241	OTHER		HEALTH NET
4	AZ0700420	OTHER	AZ	BC/BS OF ARIZONA

General Provider Information

NPI Number	:	1518943919
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOSPICE FAMILY CARE, INC.

Provider Business Mailing Address
First Line	:	PO BOX 4060
Second Line	:
City	:	MOORESVILLE
State	:	NC
Zip	:	28117-4060
Country	:	US
Telephone Number	:	704-664-2876
Fax Number	:	704-664-1306

Provider Business Practice Location Address
First Line	:	201 W GUADALUPE RD STE 308
Second Line	:
City	:	GILBERT
State	:	AZ
Zip	:	85233-3334
Country	:	US
Telephone Number	:	480-461-3144
Fax Number	:	480-844-9711

Authorized Official
Title or Position	:	VP OF LICENSURE
Name	:	JANET L. COMBS
Credential	:
Telephone Number	:	704-664-2876

Provider Enumeration Date	:	12/16/2005
Last Update Date	:	06/21/2023

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