Provider Demographics
NPI:1114007101
Name:MEDICAL SERVICES OF NEVADA INC
Entity Type:Organization
Organization Name:MEDICAL SERVICES OF NEVADA INC
Other - Org Name:ADVANCED HOME HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:REGIONAL AREA DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:EDGAR
Authorized Official - Middle Name:
Authorized Official - Last Name:JIMENEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-273-6658
Mailing Address - Street 1:343 FAIRVIEW DR STE 101
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89701-5389
Mailing Address - Country:US
Mailing Address - Phone:775-887-5683
Mailing Address - Fax:775-887-5677
Practice Address - Street 1:343 FAIRVIEW DR STE 101
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89701-5389
Practice Address - Country:US
Practice Address - Phone:775-887-8683
Practice Address - Fax:775-887-5677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
5921PCS-3OtherBHCQC
NV003013132Medicaid