MEDICARE: HEATERCOLLINS,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	253Z00000X	In Home Supportive Care Agency	5543PCS3	NV

General Provider Information

NPI Number	:	1730527847
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEATERCOLLINS,INC

Provider Business Mailing Address
First Line	:	4080 E LAKE MEAD BLVD
Second Line	:	SUITE C 101
City	:	LAS VEGAS
State	:	NV
Zip	:	89115-6466
Country	:	US
Telephone Number	:	702-731-5587
Fax Number	:	702-731-5597

Provider Business Practice Location Address
First Line	:	4080 E LAKE MEAD BLVD
Second Line	:	SUITE C 101
City	:	LAS VEGAS
State	:	NV
Zip	:	89115-6466
Country	:	US
Telephone Number	:	702-731-5587
Fax Number	:	702-731-5597

Authorized Official
Title or Position	:	OWNER
Name	:	MISS ANITA N/A COLLINS
Credential	:
Telephone Number	:	702-612-8473

Provider Enumeration Date	:	06/11/2013
Last Update Date	:	06/11/2013

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