Park Waverly Healthcare LLC
NPI 1629079975ActiveOrganization· Skilled Nursing Facility· Tucson, AZ
Skilled Nursing Facility in Tucson, Arizona, registered in NPPES in August 2005. The authorized official on file is Soon Burnam, Authorized Agent. Enrolled in Medicare as part a provider - skilled nursing facility.
Overview
| NPI | 1629079975 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Aug 9, 2005 |
| Last updated in NPPES | Feb 16, 2021 |
| Certified by provider | Feb 16, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Skilled Nursing Facility Primary | 314000000X | NCI-2639 | AZ |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part A Provider - Skilled Nursing Facility (AZ) |
|---|
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