Provider Demographics
NPI:1225377237
Name:COMPANION HOSPICE AND PALLIATIVE CARE OF MARICOPA, LLC
Entity Type:Organization
Organization Name:COMPANION HOSPICE AND PALLIATIVE CARE OF MARICOPA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGIONAL DIRECTOR OF REIMBURSEMENT
Authorized Official - Prefix:MS
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:BAYNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-664-0974
Mailing Address - Street 1:1930 S ALMA SCHOOL RD
Mailing Address - Street 2:D105
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85210-3064
Mailing Address - Country:US
Mailing Address - Phone:866-270-0356
Mailing Address - Fax:866-230-5692
Practice Address - Street 1:1930 S ALMA SCHOOL RD
Practice Address - Street 2:D105
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85210-3064
Practice Address - Country:US
Practice Address - Phone:866-270-0356
Practice Address - Fax:866-230-5692
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-11
Last Update Date:2013-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ03-1608Medicare PIN