MEDICARE: KINGMAN HEALTHCARE, 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	HSPC4872	AZ
2	251G00000X	Community Based Hospice Care Agency	SPC3040	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P0702260	OTHER	AZ	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538347836
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KINGMAN HEALTHCARE, INC

Provider Business Mailing Address
First Line	:	3269 N STOCKTON HILL RD
Second Line	:
City	:	KINGMAN
State	:	AZ
Zip	:	86409-3619
Country	:	US
Telephone Number	:	928-692-4680
Fax Number	:	928-692-4659

Provider Business Practice Location Address
First Line	:	2202 N STOCKTON HILL RD STE 200
Second Line	:
City	:	KINGMAN
State	:	AZ
Zip	:	86401-4622
Country	:	US
Telephone Number	:	928-692-4680
Fax Number	:	928-692-4659

Authorized Official
Title or Position	:	CFO
Name	:	JOSHUA HOFFMAN
Credential	:
Telephone Number	:	928-263-3087

Provider Enumeration Date	:	02/08/2008
Last Update Date	:	04/24/2026

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Directions to “KINGMAN HEALTHCARE, INC ” Practice Location

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