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NPI Code Detail

MEDICARE: EUCALYPTUS HOME CARE LLC

MEDICARE: EUCALYPTUS HOME CARE 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 Agency8420PCS-0NV

General Provider Information

NPI Number : 1811354764
Entity Type Code : Organization
Provider Name (Legal Business Name) : EUCALYPTUS HOME CARE LLC
Provider Business Mailing Address
First Line : 9205 W RUSSELL RD STE 240
Second Line :
City : LAS VEGAS
State : NV
Zip : 89148-1425
Country : US
Telephone Number : 702-534-2600
Fax Number :
Provider Business Practice Location Address
First Line : 9205 W RUSSELL RD STE 240
Second Line :
City : LAS VEGAS
State : NV
Zip : 89148-1425
Country : US
Telephone Number : 702-524-2600
Fax Number :
Authorized Official
Title or Position : ADMINISTRATOR
Name : MRS. MARIEL PAMINTUAN-ESGUERRA
Credential : RN
Telephone Number : 702-340-5795
Provider Enumeration Date : 01/23/2016
Last Update Date : 01/23/2016

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Directions to “EUCALYPTUS HOME CARE LLC ” Practice Location

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