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NPI Code Detail

MEDICARE: ANCILE PALLIATIVE CARE, INC

MEDICARE: ANCILE PALLIATIVE CARE, INC
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
1251G00000XCommunity Based Hospice Care AgencyNV20121349662NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1NV20121349662OTHERNVNEVADA BUSINESS IDENTIFICATION

General Provider Information

NPI Number : 1164779906
Entity Type Code : Organization
Provider Name (Legal Business Name) : ANCILE PALLIATIVE CARE, INC
Provider Business Mailing Address
First Line : 9315 W SUNSET RD
Second Line : SUITE 101-C
City : LAS VEGAS
State : NV
Zip : 89148-5011
Country : US
Telephone Number : 702-985-1944
Fax Number : 702-405-0161
Provider Business Practice Location Address
First Line : 9315 W SUNSET RD
Second Line : SUITE 101-C
City : LAS VEGAS
State : NV
Zip : 89148-5011
Country : US
Telephone Number : 702-985-1944
Fax Number : 702-405-0161
Authorized Official
Title or Position : ASST. ADMINISTRATOR
Name : ELISA A RODRIGUEZ
Credential :
Telephone Number : 702-985-1944
Provider Enumeration Date : 08/10/2012
Last Update Date : 08/10/2012

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Directions to “ANCILE PALLIATIVE CARE, INC ” Practice Location

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