MEDICARE: MMC HEALTHCARE 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	251G00000X	Community Based Hospice Care Agency

General Provider Information

NPI Number	:	1831945153
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MMC HEALTHCARE LLC

Provider Business Mailing Address
First Line	:	3824 S JONES BLVD STE C
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-2451
Country	:	US
Telephone Number	:	725-205-2935
Fax Number	:	725-205-3015

Provider Business Practice Location Address
First Line	:	3824 S JONES BLVD STE C
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-2451
Country	:	US
Telephone Number	:	725-205-2935
Fax Number	:	725-205-3015

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	DEMAE CONCEPCION
Credential	:
Telephone Number	:	725-205-2935

Provider Enumeration Date	:	04/26/2024
Last Update Date	:	04/26/2024

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Directions to “MMC HEALTHCARE LLC ” Practice Location

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