Healthcare Provider Details

I. General information

NPI: 1306348248
Provider Name (Legal Business Name): CVS HOME CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2018
Last Update Date: 03/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7465 W LAKE MEAD BLVD STE 100
LAS VEGAS NV
89128-1033
US

IV. Provider business mailing address

7465 W LAKE MEAD BLVD STE 100
LAS VEGAS NV
89128-1033
US

V. Phone/Fax

Practice location:
  • Phone: 702-560-4900
  • Fax:
Mailing address:
  • Phone: 702-560-4900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number StateNV
# 3
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateNV
# 4
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateNV
# 5
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care
License Number
License Number StateNV

VIII. Authorized Official

Name: VILMA AFANTE
Title or Position: VICE PRESIDENT
Credential:
Phone: 702-560-4900