Provider Demographics
NPI:1861907917
Name:SDX HOME CARE OPERATIONS, LLC
Entity type:Organization
Organization Name:SDX HOME CARE OPERATIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:
Authorized Official - Last Name:AZANKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-621-9649
Mailing Address - Street 1:2935 MARICOPA AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:LAKE HAVASU CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86406-9290
Mailing Address - Country:US
Mailing Address - Phone:928-855-0005
Mailing Address - Fax:
Practice Address - Street 1:2250 MCCULLOCH BLVD N STE C
Practice Address - Street 2:
Practice Address - City:LAKE HAVASU CITY
Practice Address - State:AZ
Practice Address - Zip Code:86403-5988
Practice Address - Country:US
Practice Address - Phone:928-855-0005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SDX HOME CARE OPERATIONS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-12-12
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care