MEDICARE: PAINTED SKY 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

General Provider Information

NPI Number	:	1548821838
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PAINTED SKY HEALTHCARE, INC.

Provider Business Mailing Address
First Line	:	4400 E BROADWAY BLVD STE 400
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85711-3553
Country	:	US
Telephone Number	:	520-207-5817
Fax Number	:

Provider Business Practice Location Address
First Line	:	4400 E BROADWAY BLVD STE 400
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85711-3553
Country	:	US
Telephone Number	:	520-207-5817
Fax Number	:

Authorized Official
Title or Position	:	SECRETARY
Name	:	AMBER L TUELLER
Credential	:
Telephone Number	:	208-207-2726

Provider Enumeration Date	:	06/26/2019
Last Update Date	:	01/16/2025

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