MEDICARE: PILLAR HOME HEALTH LLC

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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1659269421
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PILLAR HOME HEALTH LLC

Provider Business Mailing Address
First Line	:	2410 FIRE MESA STREET SUITE 130, UNIT 111
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128
Country	:	US
Telephone Number	:	702-803-8880
Fax Number	:	702-803-8885

Provider Business Practice Location Address
First Line	:	2410 FIRE MESA STREET SUITE 130, UNIT 111
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-9024
Country	:	US
Telephone Number	:	702-803-8880
Fax Number	:	702-803-8885

Authorized Official
Title or Position	:	MEMBER
Name	:	KARINE YAZIDZHYAN
Credential	:
Telephone Number	:	702-803-8880

Provider Enumeration Date	:	06/27/2025
Last Update Date	:	06/27/2025

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