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NPI Code Detail

MEDICARE: HEARTHSTONE HOSPITAL - SUN CITY, LLC

MEDICARE: HEARTHSTONE HOSPITAL - SUN CITY, 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
1282N00000XGeneral Acute Care Hospital
2282E00000XLong Term Care HospitalSH 4387AZ
3314000000XSkilled Nursing Facility

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
103-2008OTHERAZMEDICARE
2035128OTHERAZMEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1578690988
Entity Type Code : Organization
Provider Name (Legal Business Name) : HEARTHSTONE HOSPITAL - SUN CITY, LLC
Provider Business Mailing Address
First Line : 4440 N CIVIC CENTER PLZ
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85251-3513
Country : US
Telephone Number : 480-945-7711
Fax Number : 480-945-8266
Provider Business Practice Location Address
First Line : 13818 N THUNDERBIRD BLVD
Second Line :
City : SUN CITY
State : AZ
Zip : 85351-2574
Country : US
Telephone Number : 480-945-7711
Fax Number : 480-945-8266
Authorized Official
Title or Position : CEO
Name : MR. GLENN DE SOUZA
Credential :
Telephone Number : 480-945-7711
Provider Enumeration Date : 02/27/2007
Last Update Date : 09/01/2009

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