MEDICARE: NEVADA HEALTH CENTERS, 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	261QF0400X	Federally Qualified Health Center (FQHC)		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	:	1649398512
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEVADA HEALTH CENTERS, INC.

Provider Business Mailing Address
First Line	:	1802 N CARSON ST
Second Line	:	SUITE 100
City	:	CARSON CITY
State	:	NV
Zip	:	89701-1215
Country	:	US
Telephone Number	:	775-888-6610
Fax Number	:	775-887-7046

Provider Business Practice Location Address
First Line	:	400 SHADOW LN
Second Line	:	SUITE 106
City	:	LAS VEGAS
State	:	NV
Zip	:	89106-4363
Country	:	US
Telephone Number	:	702-253-7802
Fax Number	:	702-633-6474

Authorized Official
Title or Position	:	CEO
Name	:	THOMAS G CHASE
Credential	:
Telephone Number	:	775-887-1590

Provider Enumeration Date	:	03/27/2007
Last Update Date	:	10/07/2010

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