MEDICARE: SIERRA HOME MEDICAL PRODUCTS 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	3336C0004X	Compounding Pharmacy
2	3336H0001X	Home Infusion Therapy Pharmacy
3	3336L0003X	Long Term Care Pharmacy	PH01261	NV
4	3336S0011X	Specialty Pharmacy
5	333600000X	Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2056443	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1467488148
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SIERRA HOME MEDICAL PRODUCTS INC

Provider Business Mailing Address
First Line	:	PO BOX 35380
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89133-5380
Country	:	US
Telephone Number	:	702-579-3203
Fax Number	:

Provider Business Practice Location Address
First Line	:	6720 PLACID ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-3541
Country	:	US
Telephone Number	:	702-796-1016
Fax Number	:	702-796-0818

Authorized Official
Title or Position	:	REGIONAL MANAGER
Name	:	EMILY CASTILLO
Credential	:
Telephone Number	:	702-480-2550

Provider Enumeration Date	:	06/24/2006
Last Update Date	:	10/25/2023

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