Provider Demographics
NPI:1225069024
Name:FIRSTAT HOME HEALTH SERVICES, LLC
Entity Type:Organization
Organization Name:FIRSTAT HOME HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:THOEMKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-627-9563
Mailing Address - Street 1:7310 N 16TH ST
Mailing Address - Street 2:STE 135
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-5258
Mailing Address - Country:US
Mailing Address - Phone:602-279-0000
Mailing Address - Fax:602-279-6666
Practice Address - Street 1:7310 N 16TH ST
Practice Address - Street 2:STE 135
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-5258
Practice Address - Country:US
Practice Address - Phone:602-279-0000
Practice Address - Fax:602-279-6666
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2010-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZHHA3699251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ039891Medicaid
AZ037235Medicare ID - Type Unspecified