MEDICARE: PCAS OF NEVADA 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	1000020-319	NV

General Provider Information

NPI Number	:	1124080411
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PCAS OF NEVADA INC

Provider Business Mailing Address
First Line	:	1515 E TROPICANA AVE
Second Line	:	SUITE 690
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-6517
Country	:	US
Telephone Number	:	702-697-1200
Fax Number	:	702-697-1300

Provider Business Practice Location Address
First Line	:	1515 E TROPICANA AVE
Second Line	:	SUITE 690
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-6517
Country	:	US
Telephone Number	:	702-697-1200
Fax Number	:	702-697-1300

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. MADYLEN CAROL CHESNUT
Credential	:
Telephone Number	:	702-697-1200

Provider Enumeration Date	:	04/04/2006
Last Update Date	:	08/22/2020

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