Provider Demographics
NPI:1558753558
Name:AZ HOSPICE LLC
Entity Type:Organization
Organization Name:AZ HOSPICE LLC
Other - Org Name:AZ HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:AHMED
Authorized Official - Middle Name:A
Authorized Official - Last Name:ZAKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-309-1392
Mailing Address - Street 1:1230 S LINDEN RD
Mailing Address - Street 2:STE 2
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3459
Mailing Address - Country:US
Mailing Address - Phone:810-309-1392
Mailing Address - Fax:810-309-1395
Practice Address - Street 1:1230 S LINDEN RD
Practice Address - Street 2:STE 2
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3459
Practice Address - Country:US
Practice Address - Phone:810-309-1392
Practice Address - Fax:810-309-1395
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-27
Last Update Date:2015-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based