MEDICARE: ANCHOR HOMECARE 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	253Z00000X	In Home Supportive Care Agency
2	251E00000X	Home Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1841704137	OTHER		MY NPI NUMBER

General Provider Information

NPI Number	:	1891356770
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANCHOR HOMECARE LLC

Provider Business Mailing Address
First Line	:	3151 SOARING GULLS DR UNIT 2058
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-7037
Country	:	US
Telephone Number	:	702-686-4698
Fax Number	:

Provider Business Practice Location Address
First Line	:	1508 WINWOOD ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89108-1575
Country	:	US
Telephone Number	:	702-686-4698
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	HEATHER ANN MADISON
Credential	:	PCA
Telephone Number	:	702-686-4698

Provider Enumeration Date	:	06/22/2019
Last Update Date	:	08/27/2020

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Directions to “ANCHOR HOMECARE LLC ” Practice Location

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