Provider Demographics
NPI:1295181055
Name:MEDICAL SERVICES OF NEVADA
Entity Type:Organization
Organization Name:MEDICAL SERVICES OF NEVADA
Other - Org Name:ALL VALLEY HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AREA MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CASSIAH
Authorized Official - Middle Name:
Authorized Official - Last Name:DEPEW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-249-0837
Mailing Address - Street 1:1325 AIRMOTIVE WAY
Mailing Address - Street 2:ST 262
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-3201
Mailing Address - Country:US
Mailing Address - Phone:775-828-6420
Mailing Address - Fax:775-828-6413
Practice Address - Street 1:1325 AIRMOTIVE WAY
Practice Address - Street 2:ST 262
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-3201
Practice Address - Country:US
Practice Address - Phone:775-828-6420
Practice Address - Fax:775-828-6413
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-11
Last Update Date:2016-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV5445PCO-7253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1548508591Medicaid
NV1427138338Medicaid
NV9005042153Medicaid