Provider Demographics
NPI:1568194504
Name:EMERALD HOSPICE CARE INC
Entity Type:Organization
Organization Name:EMERALD HOSPICE CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:YERAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GHAZARYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-459-4093
Mailing Address - Street 1:13231 N 35TH AVE STE A12-7
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85029-1233
Mailing Address - Country:US
Mailing Address - Phone:928-459-4093
Mailing Address - Fax:
Practice Address - Street 1:13231 N 35TH AVE STE A12-7
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85029-1233
Practice Address - Country:US
Practice Address - Phone:928-459-4093
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-28
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based