MEDICARE: UNIMED 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	:	1770353328
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNIMED HOME HEALTH LLC

Provider Business Mailing Address
First Line	:	6272 SPRING MOUNTAIN RD STE 105
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-8876
Country	:	US
Telephone Number	:	702-769-8833
Fax Number	:	702-748-8326

Provider Business Practice Location Address
First Line	:	6272 SPRING MOUNTAIN RD STE 105
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-8876
Country	:	US
Telephone Number	:	702-769-8833
Fax Number	:	702-748-8326

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. OSCAR JAY BUSTAMANTE
Credential	:
Telephone Number	:	702-722-7609

Provider Enumeration Date	:	01/04/2024
Last Update Date	:	01/08/2024

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Directions to “UNIMED HOME HEALTH LLC ” Practice Location

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