Provider Demographics
NPI:1225336571
Name:INFINITY HOSPICE CARE OF RENO LLC
Entity Type:Organization
Organization Name:INFINITY HOSPICE CARE OF RENO LLC
Other - Org Name:INFINITY HOSPICE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:BERTRAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-381-0375
Mailing Address - Street 1:5538 LONGLEY LN
Mailing Address - Street 2:SUITE B
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-1897
Mailing Address - Country:US
Mailing Address - Phone:775-852-6002
Mailing Address - Fax:775-852-6028
Practice Address - Street 1:5538 LONGLEY LN
Practice Address - Street 2:SUITE B
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-1897
Practice Address - Country:US
Practice Address - Phone:775-852-6002
Practice Address - Fax:775-852-6028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-10
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV20101781618251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV291530Medicare Oscar/Certification