MEDICARE: CAREMERIDIAN, 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	314000000X	Skilled Nursing Facility	3564SNF-5	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083707764
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAREMERIDIAN, LLC

Provider Business Mailing Address
First Line	:	163 TECHNOLOGY DR STE 200
Second Line	:
City	:	IRVINE
State	:	CA
Zip	:	92618-2486
Country	:	US
Telephone Number	:	949-794-0787
Fax Number	:	949-261-0457

Provider Business Practice Location Address
First Line	:	7690 CARMEN BLVD.
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128
Country	:	US
Telephone Number	:	702-255-7399
Fax Number	:	702-255-4310

Authorized Official
Title or Position	:	DIRECTOR OF FINANCE
Name	:	MR. SEAN SHEA
Credential	:
Telephone Number	:	617-688-5251

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	08/13/2019

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Directions to “CAREMERIDIAN, LLC ” Practice Location

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