Provider Demographics
NPI:1225852619
Name:AZURA PALLIATIVE CARE AND HOSPICE WI, LLC
Entity type:Organization
Organization Name:AZURA PALLIATIVE CARE AND HOSPICE WI, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:NORTHERN
Authorized Official - Suffix:
Authorized Official - Credentials:CSW
Authorized Official - Phone:414-731-1172
Mailing Address - Street 1:1233 N MAYFAIR RD STE 301
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3255
Mailing Address - Country:US
Mailing Address - Phone:414-731-1172
Mailing Address - Fax:414-677-7319
Practice Address - Street 1:1233 N MAYFAIR RD STE 301
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-3255
Practice Address - Country:US
Practice Address - Phone:414-731-1172
Practice Address - Fax:414-677-7319
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-12
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based