Provider Demographics
NPI:1891398079
Name:ST PETERS HOSPICE CARE LLC
Entity Type:Organization
Organization Name:ST PETERS HOSPICE CARE LLC
Other - Org Name:ST PETERS HOSPICE CARE LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HOVHANNES
Authorized Official - Middle Name:
Authorized Official - Last Name:KARAGEZYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-887-3060
Mailing Address - Street 1:628 N 24TH ST STE D
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85008-6016
Mailing Address - Country:US
Mailing Address - Phone:623-476-9198
Mailing Address - Fax:
Practice Address - Street 1:628 N 24TH ST STE D
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85008-6016
Practice Address - Country:US
Practice Address - Phone:623-476-9198
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-19
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based