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NPI Code Detail

MEDICARE: INFINITY HOSPICE CARE OF LAS VEGAS LLC

MEDICARE: INFINITY HOSPICE CARE OF LAS VEGAS 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
1251G00000XCommunity Based Hospice Care Agency4890HPC-1NV

General Provider Information

NPI Number : 1609040237
Entity Type Code : Organization
Provider Name (Legal Business Name) : INFINITY HOSPICE CARE OF LAS VEGAS LLC
Provider Business Mailing Address
First Line : 5110 N 40TH ST
Second Line : SUITE 107
City : PHOENIX
State : AZ
Zip : 85018-2126
Country : US
Telephone Number : 602-381-0375
Fax Number :
Provider Business Practice Location Address
First Line : 6330 SOUTH JONES BOULEVARD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89118-3302
Country : US
Telephone Number : 702-880-7002
Fax Number :
Authorized Official
Title or Position : CHIEF EXECUTIVE OFFICER
Name : DARREN RAYMOND BERTRAM
Credential :
Telephone Number : 602-381-0375
Provider Enumeration Date : 04/15/2008
Last Update Date : 06/07/2013

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Directions to “INFINITY HOSPICE CARE OF LAS VEGAS LLC ” Practice Location

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