MEDICARE: SUNRISE HOSPICE 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

General Provider Information

NPI Number	:	1588264634
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNRISE HOSPICE CARE INC

Provider Business Mailing Address
First Line	:	8275 S EASTERN AVE STE 261
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-2519
Country	:	US
Telephone Number	:	725-235-3840
Fax Number	:

Provider Business Practice Location Address
First Line	:	8275 S EASTERN AVE STE 261
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-2519
Country	:	US
Telephone Number	:	725-235-3840
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	ANDY KECHEJIAN
Credential	:
Telephone Number	:	725-235-3840

Provider Enumeration Date	:	10/28/2020
Last Update Date	:	02/04/2022

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