MEDICARE: PEDIATRIC HOME HEALTH CARE OF NEVADA LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1023747078
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEDIATRIC HOME HEALTH CARE OF NEVADA LLC

Provider Business Mailing Address
First Line	:	3037 E WARM SPRINGS RD STE 300B
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-3759
Country	:	US
Telephone Number	:	702-527-7429
Fax Number	:

Provider Business Practice Location Address
First Line	:	3037 E WARM SPRINGS RD STE 100
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-3759
Country	:	US
Telephone Number	:	702-250-1821
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	EDDIE BELLUOMINI
Credential	:	RN
Telephone Number	:	808-450-5035

Provider Enumeration Date	:	06/06/2022
Last Update Date	:	09/08/2025

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