Active NPI
Supreme Care Hospice Inc
- Community Based Hospice Care Agency
- Phoenix, AZ
National Provider Identifier
1689337297
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Based Hospice Care Agency
- Legal business name
- SUPREME CARE HOSPICE INC
- Practice address
- 13201 N 35TH Ave Ste B7A
Phoenix, AZ 85029-1222 - Phone
- (323) 394-8000
- NPI assigned
- Oct 20, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jerry Bordeleau
- Title
- Ceo
- Phone
- (602) 881-8170
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | Primary |
Addresses
Primary practice location
13201 N 35TH Ave Ste B7A
Phoenix, AZ 85029-1222
Mailing address
13201 N 35TH Ave Ste B7A
Phoenix, AZ 85029-1222
Phone (602) 881-8170
Other names 1
- Supreme Care Hospice Inc
Care Compare: Hospice
Medicare Care Compare- Listed as
- Supreme Care Hospice Inc
- Certified
- Apr 5, 2023
- Medicare certification status
- Active
Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address. The facility is not in the current Medicare enrollment files, which can mean its Medicare enrollment has ended (or, for VA and military hospitals, that it does not enroll).
National Provider Directory
National Provider DirectoryLocations
13201 N 35th Ave
Ste B7A
Phoenix, AZ 85029
Phone (323) 394-8000
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1634688000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1707264000000",
"number": "1689337297",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13201 N 35TH AVE STE B7A",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850291222",
"telephone_number": "602-881-8170"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13201 N 35TH AVE STE B7A",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850291222",
"telephone_number": "323-394-8000"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SUPREME CARE HOSPICE INC",
"organizational_subpart": "NO",
"enumeration_date": "2021-10-20",
"last_updated": "2024-02-07",
"certification_date": "2024-02-07",
"status": "A",
"authorized_official_last_name": "BORDELEAU",
"authorized_official_first_name": "JERRY",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "602-881-8170"
},
"taxonomies": [
{
"code": "251G00000X",
"taxonomy_group": "",
"desc": "Hospice Care, Community Based",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Supreme Care Hospice Inc",
"code": "4",
"type": "Former Legal Business Name"
},
{
"organization_name": "Supreme Care Hospice Inc",
"code": "4",
"type": "Former Legal Business Name"
}
]
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.