MEDICARE: PROFESSIONAL HEALTHCARE STAFFING INC

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	603HHA-13	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043352529
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROFESSIONAL HEALTHCARE STAFFING INC

Provider Business Mailing Address
First Line	:	2820 W. CHARLESTON BLVD.
Second Line	:	SUITE # 36
City	:	LAS VEGAS
State	:	NV
Zip	:	89102
Country	:	US
Telephone Number	:	702-362-0711
Fax Number	:	702-362-8222

Provider Business Practice Location Address
First Line	:	2820 W CHARLESTON BLVD
Second Line	:	SUITE # 36
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-1942
Country	:	US
Telephone Number	:	702-362-0711
Fax Number	:	702-362-8222

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JOSEPH P STRUCK
Credential	:	ADMINSTRATOR
Telephone Number	:	702-362-0711

Provider Enumeration Date	:	02/13/2007
Last Update Date	:	04/15/2024

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