Provider Demographics
NPI:1073988580
Name:AZ BEST HOSPICE
Entity Type:Organization
Organization Name:AZ BEST HOSPICE
Other - Org Name:BEST HOSPICE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:WILBUR
Authorized Official - Middle Name:ABALOS
Authorized Official - Last Name:PULIDO
Authorized Official - Suffix:
Authorized Official - Credentials:DBA
Authorized Official - Phone:928-783-0705
Mailing Address - Street 1:291 S MAIN ST
Mailing Address - Street 2:SUITE L
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-1414
Mailing Address - Country:US
Mailing Address - Phone:928-783-0705
Mailing Address - Fax:928-783-4349
Practice Address - Street 1:291 S MAIN ST
Practice Address - Street 2:SUITE L
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-1414
Practice Address - Country:US
Practice Address - Phone:928-783-0705
Practice Address - Fax:928-783-4349
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-09
Last Update Date:2015-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZHSPC5642251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ031627Medicare PIN