Provider Demographics
NPI:1790259927
Name:AZ HOSPICE CARE INC
Entity Type:Organization
Organization Name:AZ HOSPICE CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:
Authorized Official - Last Name:RENNER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:480-645-9640
Mailing Address - Street 1:1825 E NORTHERN AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-3953
Mailing Address - Country:US
Mailing Address - Phone:480-645-9640
Mailing Address - Fax:480-645-9641
Practice Address - Street 1:1825 E NORTHERN AVE STE 100
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-3953
Practice Address - Country:US
Practice Address - Phone:480-645-9640
Practice Address - Fax:480-645-9641
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-22
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based