Provider Demographics
NPI:1750321154
Name:FOUNDERS HEALTHCARE, LLC
Entity Type:Organization
Organization Name:FOUNDERS HEALTHCARE, LLC
Other - Org Name:PREFERRED HOMECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF OPERATIONS OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCARTHY
Authorized Official - Suffix:
Authorized Official - Credentials:AO
Authorized Official - Phone:727-259-2255
Mailing Address - Street 1:PO BOX 40700
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85274-0700
Mailing Address - Country:US
Mailing Address - Phone:480-446-9010
Mailing Address - Fax:480-993-2033
Practice Address - Street 1:120 E PHOENIX AVE
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001-5768
Practice Address - Country:US
Practice Address - Phone:928-773-9493
Practice Address - Fax:928-634-2427
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-07
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
AZ204332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ403832Medicaid
AZ1196990005Medicare NSC