MEDICARE: LAS VEGAS HOSPICE 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
1	251G00000X	Community Based Hospice Care Agency

General Provider Information

NPI Number	:	1366953556
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAS VEGAS HOSPICE CARE INC

Provider Business Mailing Address
First Line	:	8872 S EASTERN AVE STE 290A
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-4900
Country	:	US
Telephone Number	:	702-805-1912
Fax Number	:	702-805-0034

Provider Business Practice Location Address
First Line	:	8872 S EASTERN AVE STE 290A
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-4900
Country	:	US
Telephone Number	:	702-805-1912
Fax Number	:	702-805-0034

Authorized Official
Title or Position	:	PRESIDENT
Name	:	BIBI MOHAMMED
Credential	:
Telephone Number	:	702-805-1912

Provider Enumeration Date	:	10/16/2017
Last Update Date	:	10/16/2017

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Directions to “LAS VEGAS HOSPICE CARE INC ” Practice Location

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