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NPI Code Detail

MEDICARE: HEALTH AND CARE PROFESSIONAL NETWORK

MEDICARE: HEALTH AND CARE PROFESSIONAL NETWORK
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
1251E00000XHome Health Agency7872PCS-0NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
17872PCS-0OTHERNVSTATE OF NEVADA DEPARTMENT OF HEALTH AND HUMAN SERVICES

General Provider Information

NPI Number : 1215472055
Entity Type Code : Organization
Provider Name (Legal Business Name) : HEALTH AND CARE PROFESSIONAL NETWORK
Provider Business Mailing Address
First Line : 4850 W FLAMINGO RD
Second Line : 25
City : LAS VEGAS
State : NV
Zip : 89103-3705
Country : US
Telephone Number : 702-871-9917
Fax Number : 702-871-9918
Provider Business Practice Location Address
First Line : 4850 W FLAMINGO RD
Second Line : 25
City : LAS VEGAS
State : NV
Zip : 89103-3705
Country : US
Telephone Number : 702-871-9917
Fax Number : 702-871-9918
Authorized Official
Title or Position : ADMINISTRATOR
Name : MS. GEMMA VIRAY
Credential : RN
Telephone Number : 702-871-9917
Provider Enumeration Date : 01/04/2017
Last Update Date : 01/04/2017

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89103-3705
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1245889328 — LODERA PADILLA
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89103-3705
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1790335883 — ASMAYT DEBRETSION
Practice Location Address:
4850 W FLAMINGO RD
LAS VEGAS, NV
89103-3705
Practice Phone: 702-871-9917
Practice Fax:

Directions to “HEALTH AND CARE PROFESSIONAL NETWORK ” Practice Location

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