MEDICARE: NURSECORE MANAGEMENT SERVICES 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	251E00000X	Home Health Agency	HHA275	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1Z7201	OTHER	AZ	HEALTHNET
2	156107	OTHER	AZ	GENTIVA
3	PHH190030011	OTHER	AZ	APIPA
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	AZ0701860	OTHER	AZ	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1801838271
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NURSECORE MANAGEMENT SERVICES LLC

Provider Business Mailing Address
First Line	:	PO BOX 201925
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76006-1925
Country	:	US
Telephone Number	:	817-649-1166
Fax Number	:	817-649-2638

Provider Business Practice Location Address
First Line	:	300 W CLARENDON AVE STE 340
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85013-3499
Country	:	US
Telephone Number	:	602-274-3400
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	DEBORAH LOLLAR
Credential	:
Telephone Number	:	817-649-1166

Provider Enumeration Date	:	06/12/2006
Last Update Date	:	04/19/2022

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Directions to “NURSECORE MANAGEMENT SERVICES LLC ” Practice Location

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