Provider Demographics
NPI:1457724890
Name:AZ BEST HOSPICE LLC
Entity Type:Organization
Organization Name:AZ BEST HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:WILBUR
Authorized Official - Middle Name:ABALOS
Authorized Official - Last Name:PULIDO
Authorized Official - Suffix:
Authorized Official - Credentials:DBA
Authorized Official - Phone:909-801-1424
Mailing Address - Street 1:291 S MAIN ST
Mailing Address - Street 2:STE L
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-1414
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:291 S MAIN ST
Practice Address - Street 2:STE L
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-1414
Practice Address - Country:US
Practice Address - Phone:928-783-0705
Practice Address - Fax:928-783-4349
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-06
Last Update Date:2015-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ031627Medicare Oscar/Certification