1003250218 NPI number — EL SOL HOSPICE AND PALLIATIVE CARE

Table of content: (NPI 1003250218)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003250218 NPI number — EL SOL HOSPICE AND PALLIATIVE CARE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EL SOL HOSPICE AND PALLIATIVE CARE
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ELITE HOSPICE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1003250218
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/18/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9341 E MCKELLIPS RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MESA
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85207-2632
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
520-484-8484
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6336 E BROWN RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MESA
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85205-4805
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
520-484-8484
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/18/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
TAKYAR
Authorized Official First Name:
HARINDER
Authorized Official Middle Name:
K
Authorized Official Title or Position:
MEDICAL DIRECTOR
Authorized Official Telephone Number:
520-484-8484

Provider Taxonomy Codes

  • Taxonomy code: 251G00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)