MEDICARE: MARJORIE ANN GARCIA

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	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1457613663
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARJORIE ANN GARCIA

Provider Business Mailing Address
First Line	:	7943 DEXTER FALLS ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89149-3726
Country	:	US
Telephone Number	:	570-872-3887
Fax Number	:

Provider Business Practice Location Address
First Line	:	2770 S MARYLAND PKWY STE 310
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89109
Country	:	US
Telephone Number	:	702-240-3800
Fax Number	:	702-240-3001

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2012
Last Update Date	:	08/07/2018

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