MEDICARE: LAS VEGAS HANDYMAN

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	171WH0202X	Home Modifications Contractor

General Provider Information

NPI Number	:	1033775549
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAS VEGAS HANDYMAN

Provider Business Mailing Address
First Line	:	4710 W DEWEY DR STE 100
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-2287
Country	:	US
Telephone Number	:	702-896-0000
Fax Number	:

Provider Business Practice Location Address
First Line	:	4710 W DEWEY DR STE 100
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-2287
Country	:	US
Telephone Number	:	702-896-0000
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MICHAEL KLIMEK
Credential	:
Telephone Number	:	702-896-0000

Provider Enumeration Date	:	05/10/2019
Last Update Date	:	05/10/2019

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