Provider Demographics
NPI:1518191113
Name:FOCUS CARE OF ARIZONA LLC
Entity Type:Organization
Organization Name:FOCUS CARE OF ARIZONA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SIMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:AGHAULOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-315-3707
Mailing Address - Street 1:4350 E CAMELBACK RD
Mailing Address - Street 2:SUITE A110
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-2701
Mailing Address - Country:US
Mailing Address - Phone:602-955-2221
Mailing Address - Fax:602-955-1899
Practice Address - Street 1:4350 E CAMELBACK RD
Practice Address - Street 2:SUITE A110
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-2701
Practice Address - Country:US
Practice Address - Phone:602-955-2221
Practice Address - Fax:602-955-1899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-11
Last Update Date:2011-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ517250OtherMEDICAID
AZ037276Medicare UPIN