Provider Demographics
NPI:1740935360
Name:MEDICZEN HOME CARE OF WASHINGTON, LLC
Entity type:Organization
Organization Name:MEDICZEN HOME CARE OF WASHINGTON, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:NORTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-826-6536
Mailing Address - Street 1:7207 W ALTA VISTA RD
Mailing Address - Street 2:
Mailing Address - City:LAVEEN
Mailing Address - State:AZ
Mailing Address - Zip Code:85339-2669
Mailing Address - Country:US
Mailing Address - Phone:602-826-6536
Mailing Address - Fax:
Practice Address - Street 1:26327 116TH AVE SE APT E104
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98030-8452
Practice Address - Country:US
Practice Address - Phone:425-591-0302
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-14
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care