MEDICARE: THOMAS AND THOMAS PCA, 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
1	3747P1801X	Personal Care Attendant	NV20181306236	NV

General Provider Information

NPI Number	:	1003304551
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THOMAS AND THOMAS PCA, LLC

Provider Business Mailing Address
First Line	:	911 G ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89106-3313
Country	:	US
Telephone Number	:	725-777-8179
Fax Number	:

Provider Business Practice Location Address
First Line	:	911 G ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89106-3313
Country	:	US
Telephone Number	:	725-777-8179
Fax Number	:	702-386-0680

Authorized Official
Title or Position	:	AGENCY OWNER
Name	:	MRS. JENNIFER D THOMAS
Credential	:
Telephone Number	:	725-777-8179

Provider Enumeration Date	:	04/30/2018
Last Update Date	:	06/16/2018

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