MEDICARE: WWB INCORPORATED

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	5425PCS5	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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407196777
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WWB INCORPORATED

Provider Business Mailing Address
First Line	:	2001 S. JONES BLVD
Second Line	:	ADVANCED HOME HEALTH CARE SUITE. K
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-3165
Country	:	US
Telephone Number	:	702-562-3355
Fax Number	:	702-369-8284

Provider Business Practice Location Address
First Line	:	2860 E FLAMINGO RD
Second Line	:	SUITE. C
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-5271
Country	:	US
Telephone Number	:	702-562-3355
Fax Number	:	702-369-8284

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

Provider Enumeration Date	:	02/25/2013
Last Update Date	:	02/25/2013

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Directions to “WWB INCORPORATED ” Practice Location

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