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NPI Code Detail

MEDICARE: PROSPERITY DESERTNOVA CARE

MEDICARE: PROSPERITY DESERTNOVA CARE
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
1253Z00000XIn Home Supportive Care Agency

General Provider Information

NPI Number : 1598620205
Entity Type Code : Organization
Provider Name (Legal Business Name) : PROSPERITY DESERTNOVA CARE
Provider Business Mailing Address
First Line : 7301 N 16TH ST STE 102
Second Line :
City : PHOENIX
State : AZ
Zip : 85020-5266
Country : US
Telephone Number : 317-970-0796
Fax Number :
Provider Business Practice Location Address
First Line : 7301 N 16TH ST STE 102
Second Line :
City : PHOENIX
State : AZ
Zip : 85020-5266
Country : US
Telephone Number : 317-970-0796
Fax Number :
Authorized Official
Title or Position : ADMIN
Name : SHARMARKE GABA
Credential :
Telephone Number : 317-970-0796
Provider Enumeration Date : 12/16/2025
Last Update Date : 12/16/2025

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Directions to “PROSPERITY DESERTNOVA CARE ” Practice Location

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