MEDICARE: 702 HOSPICE CORP

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	:	1952698151
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	702 HOSPICE CORP

Provider Business Mailing Address
First Line	:	3305 SPRING MOUNTAIN RD STE 40
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-8622
Country	:	US
Telephone Number	:	702-534-7840
Fax Number	:

Provider Business Practice Location Address
First Line	:	3305 SPRING MOUNTAIN RD
Second Line	:	40
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-8609
Country	:	US
Telephone Number	:	702-534-7840
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MIKE WANG
Credential	:
Telephone Number	:	702-534-7840

Provider Enumeration Date	:	07/08/2011
Last Update Date	:	01/13/2023

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Directions to “702 HOSPICE CORP ” Practice Location

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