MEDICARE: WEEKEND RELIEF HEALTHCARE STAFFING

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	333600000X	Pharmacy	010-1006963499	NV

General Provider Information

NPI Number	:	1215171483
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEEKEND RELIEF HEALTHCARE STAFFING

Provider Business Mailing Address
First Line	:	PO BOX 370694
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89137-0694
Country	:	US
Telephone Number	:	888-731-4005
Fax Number	:	888-731-4005

Provider Business Practice Location Address
First Line	:	8636 INWOOD DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89145-4801
Country	:	US
Telephone Number	:	888-731-4005
Fax Number	:	888-731-4005

Authorized Official
Title or Position	:	OWNER
Name	:	MR. LAWRENCE COLEMAN
Credential	:	RPH
Telephone Number	:	888-731-4005

Provider Enumeration Date	:	04/30/2009
Last Update Date	:	04/30/2009

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