Provider Demographics
NPI:1386258648
Name:PATRIOT HOSPICE LLC
Entity type:Organization
Organization Name:PATRIOT HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HOVHANNES
Authorized Official - Middle Name:TONY
Authorized Official - Last Name:KARAGEZYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-476-9198
Mailing Address - Street 1:628 N 24TH ST STE F
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 F
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:2020-09-03
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251G00000XAgenciesHospice Care, Community Based
No163WH1000XNursing Service ProvidersRegistered NurseHospiceGroup - Single Specialty