MEDICARE: ARIZONA QUALITY CARE PROVIDERS 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
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1740610195
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARIZONA QUALITY CARE PROVIDERS LLC

Provider Business Mailing Address
First Line	:	881 W FOLLEY ST
Second Line	:
City	:	CHANDLER
State	:	AZ
Zip	:	85225-6219
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	501 W RAY RD
Second Line	:	SUITE 7
City	:	CHANDLER
State	:	AZ
Zip	:	85225-7284
Country	:	US
Telephone Number	:	480-264-5003
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MOHAMMAD LASKER
Credential	:
Telephone Number	:	480-264-5003

Provider Enumeration Date	:	11/22/2013
Last Update Date	:	11/26/2013

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