Provider Demographics
NPI:1174003024
Name:DOCTORS CHOICE HOSPICE LLC
Entity Type:Organization
Organization Name:DOCTORS CHOICE HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:
Authorized Official - Last Name:RENNER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:480-645-9640
Mailing Address - Street 1:60 E RIO SALADO PKWY STE 900
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85281-9126
Mailing Address - Country:US
Mailing Address - Phone:480-219-5415
Mailing Address - Fax:480-393-8555
Practice Address - Street 1:60 E RIO SALADO PKWY STE 900
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85281-9126
Practice Address - Country:US
Practice Address - Phone:480-219-5415
Practice Address - Fax:480-393-8555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-20
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZMED7908251G00000X
AZME7908251G00000X
251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based