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NPI Code Detail

MEDICARE: MR. SHAGE VINCE MALIWAT TANHUECO RN

MEDICARE: MR. SHAGE VINCE MALIWAT TANHUECO RN
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
1163WH0200XHome Health Registered Nurse895075NV

General Provider Information

NPI Number : 1508709650
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. SHAGE VINCE MALIWAT TANHUECO RN
Provider Business Mailing Address
First Line : 2950 E FLAMINGO RD STE H
Second Line :
City : LAS VEGAS
State : NV
Zip : 89121-5208
Country : US
Telephone Number : 725-251-3854
Fax Number : 725-780-1114
Provider Business Practice Location Address
First Line : 2950 E FLAMINGO RD STE H
Second Line :
City : LAS VEGAS
State : NV
Zip : 89121-5208
Country : US
Telephone Number : 725-251-3854
Fax Number : 725-780-1114
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/13/2026
Last Update Date : 04/13/2026

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