MEDICARE: 247 HOME HEALTH CARE ARIZONA 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

General Provider Information

NPI Number	:	1982148987
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	247 HOME HEALTH CARE ARIZONA LLC

Provider Business Mailing Address
First Line	:	8055 E TUFTS AVE STE 250
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80237-2857
Country	:	US
Telephone Number	:	303-548-2720
Fax Number	:

Provider Business Practice Location Address
First Line	:	1322 S ROSEANN
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85209-3738
Country	:	US
Telephone Number	:	303-548-2720
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	TAMARA LINDGREN
Credential	:	RN
Telephone Number	:	303-548-2720

Provider Enumeration Date	:	12/09/2016
Last Update Date	:	12/09/2016

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