MEDICARE: INTERIM HEALTHCARE OF NEVADA, 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	251E00000X	Home Health Agency	564HHA15	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326084260
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTERIM HEALTHCARE OF NEVADA, INC.

Provider Business Mailing Address
First Line	:	5506 S FORT APACHE RD
Second Line	:	SUITE 100
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-7672
Country	:	US
Telephone Number	:	702-369-5533
Fax Number	:	702-242-4769

Provider Business Practice Location Address
First Line	:	5506 S FORT APACHE RD
Second Line	:	SUITE 100
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-7672
Country	:	US
Telephone Number	:	702-369-5533
Fax Number	:	702-242-4769

Authorized Official
Title or Position	:	OWNER
Name	:	MR. JIM FEW
Credential	:
Telephone Number	:	702-369-5533

Provider Enumeration Date	:	06/21/2006
Last Update Date	:	10/23/2013

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