MEDICARE: A COMPASSIONATE HEALTHCARE 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	253Z00000X	In Home Supportive Care Agency	NV20121335447	NV

General Provider Information

NPI Number	:	1154768646
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A COMPASSIONATE HEALTHCARE LLC

Provider Business Mailing Address
First Line	:	9745 MONTCLAIR HEIGHTS CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89178-7509
Country	:	US
Telephone Number	:	702-234-9088
Fax Number	:

Provider Business Practice Location Address
First Line	:	6180 W.VIKING RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89178
Country	:	US
Telephone Number	:	702-234-9088
Fax Number	:

Authorized Official
Title or Position	:	ADMENISTRETOR
Name	:	MS. SHARIFA G WAHAB
Credential	:
Telephone Number	:	702-234-9088

Provider Enumeration Date	:	05/24/2013
Last Update Date	:	05/24/2013

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