Provider Demographics
NPI:1760449409
Name:APACHE HEALTHCARE SERVICES INC.
Entity Type:Organization
Organization Name:APACHE HEALTHCARE SERVICES INC.
Other - Org Name:SUNRISE HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO, PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TARIK
Authorized Official - Middle Name:M
Authorized Official - Last Name:SHIRIF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-246-3593
Mailing Address - Street 1:105 N. PASADENA ST.
Mailing Address - Street 2:STE 2
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85233-5013
Mailing Address - Country:US
Mailing Address - Phone:480-926-0133
Mailing Address - Fax:480-926-6377
Practice Address - Street 1:105 N. PASADENA ST.
Practice Address - Street 2:STE 2
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85233-5013
Practice Address - Country:US
Practice Address - Phone:480-926-0133
Practice Address - Fax:480-926-6377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-27
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZHHA3315251E00000X
AZHHA3958251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0209350OtherBC/BS OF AZ
AZ923567Medicaid
AZAZ0039710OtherBC/BS DME
AZ923567Medicaid
AZ=========OtherBC/BS OF AZ