Provider Demographics
NPI:1720073422
Name:WESTERN ARIZONA REGIONAL HOME HEALTH AND HOSPICE INC.
Entity type:Organization
Organization Name:WESTERN ARIZONA REGIONAL HOME HEALTH AND HOSPICE INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SR DIR, BUSINESS OFFICE SUPPORT
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLTSFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-465-7466
Mailing Address - Street 1:7384 N LA CHOLLA BLVD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85741-2305
Mailing Address - Country:US
Mailing Address - Phone:520-441-9914
Mailing Address - Fax:520-989-3763
Practice Address - Street 1:7384 N LA CHOLLA BLVD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85741-2305
Practice Address - Country:US
Practice Address - Phone:520-441-9914
Practice Address - Fax:520-989-3763
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-19
Last Update Date:2014-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZHSPC3821251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ031534Medicare Oscar/Certification
AZ031534Medicare Oscar/Certification