MEDICARE: DIDC 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
1	253Z00000X	In Home Supportive Care Agency	5401PCS-3	NV

General Provider Information

NPI Number	:	1306183439
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIDC INC.

Provider Business Mailing Address
First Line	:	2001 S JONES BLVD STE J
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-3165
Country	:	US
Telephone Number	:	702-562-2273
Fax Number	:

Provider Business Practice Location Address
First Line	:	535 S DECATUR BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89107-3910
Country	:	US
Telephone Number	:	702-562-2273
Fax Number	:

Authorized Official
Title or Position	:	AREA MANAGER
Name	:	MR. EDGAR V. JIMENEZ
Credential	:
Telephone Number	:	702-273-6658

Provider Enumeration Date	:	01/09/2013
Last Update Date	:	04/03/2025

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