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NPI Code Detail

MEDICARE: AULTRUCARE LLC

MEDICARE: AULTRUCARE 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
1253Z00000XIn Home Supportive Care Agency

General Provider Information

NPI Number : 1316588791
Entity Type Code : Organization
Provider Name (Legal Business Name) : AULTRUCARE LLC
Provider Business Mailing Address
First Line : 11500 S EASTERN AVE STE 150
Second Line :
City : HENDERSON
State : NV
Zip : 89052-5576
Country : US
Telephone Number : 702-848-5564
Fax Number :
Provider Business Practice Location Address
First Line : 11500 S EASTERN AVE STE 150
Second Line :
City : HENDERSON
State : NV
Zip : 89052-5576
Country : US
Telephone Number : 702-848-5564
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : MR. TIMOTHY ANDRES
Credential :
Telephone Number : 702-848-5564
Provider Enumeration Date : 10/07/2019
Last Update Date : 02/06/2020

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Directions to “AULTRUCARE LLC ” Practice Location

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