Provider Demographics
NPI:1457778425
Name:COMFORT CARE HOSPICE INC
Entity Type:Organization
Organization Name:COMFORT CARE HOSPICE INC
Other - Org Name:SAVIOR HOSPICE, LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-320-4733
Mailing Address - Street 1:4530 E SHEA BLVD STE 160
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85028-6042
Mailing Address - Country:US
Mailing Address - Phone:480-320-4733
Mailing Address - Fax:888-920-7164
Practice Address - Street 1:4530 E SHEA BLVD
Practice Address - Street 2:SUITE 160
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85028
Practice Address - Country:US
Practice Address - Phone:480-320-4733
Practice Address - Fax:888-920-7164
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-27
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZHSPC7975251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
031651OtherMEDICARE OSCAR/CERTIFICATION
AZHSPC7975OtherSTATE LICENSE
031651OtherMEDICARE OSCAR/CERTIFICATION