MEDICARE: BACCHUS PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	363L00000X	Nurse Practitioner
2	207R00000X	Internal Medicine Physician
3	363A00000X	Physician Assistant
4	261QU0200X	Urgent Care Clinic/Center
5	208D00000X	General Practice Physician
6	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1134628480
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BACCHUS PC

Provider Business Mailing Address
First Line	:	2370 CORPORATE CIR STE 300
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89074-7760
Country	:	US
Telephone Number	:	702-910-3950
Fax Number	:	702-786-6650

Provider Business Practice Location Address
First Line	:	880 SEVEN HILLS DR STE 140
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89052-4372
Country	:	US
Telephone Number	:	702-844-4840
Fax Number	:	702-844-4843

Authorized Official
Title or Position	:	CREDENTIALING MANAGER
Name	:	BEVERLY DENDARY
Credential	:
Telephone Number	:	702-910-3950

Provider Enumeration Date	:	02/01/2018
Last Update Date	:	04/01/2026

Similar Medicare Providers

1407315393 — BAILEY BUNDY WAGNER MD
Practice Location Address:

880 SEVEN HILLS DR STE 140
HENDERSON, NV
89052-4372

Practice Phone: 702-844-4840
Practice Fax: 702-778-2264

1669028106 — HAROLD ZILBERMAN M D CHTD
Practice Location Address:

880 SEVEN HILLS DR STE 100
HENDERSON, NV
89052-4372

Practice Phone: 702-457-5437
Practice Fax: 702-464-5801

1831733542 — MR. MICHAEL A SCHRECKENGOST FNP-BC
Practice Location Address:

880 SEVEN HILLS DR STE 140
HENDERSON, NV
89052-4372

Practice Phone: 702-844-4840
Practice Fax:

1891328217 — HAROLD ZILBERMAN MD CHARTERED
Practice Location Address:

880 SEVEN HILLS DR STE 100
HENDERSON, NV
89052-4372

Practice Phone: 702-457-5437
Practice Fax: 725-214-3003

1013520279 — CATHERINE FERGUSON FNP-C
Practice Location Address:

880 SEVEN HILLS DR STE 140
HENDERSON, NV
89052-4372

Practice Phone: 702-844-4840
Practice Fax: 702-844-4843

1457066441 — CAPENER AND SANFORD LLC
Practice Location Address:

880 SEVEN HILLS DR STE 130
HENDERSON, NV
89052-4372

Practice Phone: 702-914-4478
Practice Fax:

Directions to “BACCHUS PC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.