TRADITIONS HOSPICE OF ARIZONA III LLC NPI 1295038297

NPI Information

NPI: 1295038297
Provider Name: TRADITIONS HOSPICE OF ARIZONA III, LLC

Doing Business As: TRADITIONS HEALTH

Classification: Hospice Care, Community Based - 251G00000X
Entity Type: Organization

Address:
1840 EAST UNIVERSITY DRIVE
SUITE 6
MESA, AZ
ZIP 85203
Phone: (480) 246-3560
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TRADITIONS HOSPICE OF ARIZONA III, LLC is a hospice care community based in Mesa, AZ. TRADITIONS HOSPICE OF ARIZONA III, LLC NPI is 1295038297. The provider is registered as an organization entity type.
The provider Is Doing Business As Traditions Health.

The provider's business location address is:

1840 EAST UNIVERSITY DRIVE
SUITE 6
MESA, AZ
ZIP 85203
Phone: (480) 246-3560
Fax: (480) 246-3561

The provider's authorized official is David R Klementz .
The authorized official title is President & Ceo and has the following contact phone number (979) 704-6547.

The CLIA number assigned to this NPI record is 03D2164436 - hospice with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/13/2010 and was last updated on 9/22/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	251G00000X	Hospice Care, Community Based		HSPC4985	ARIZONA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	829168	MEDICAID	ARIZONA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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