Provider Demographics
NPI:1699191817
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:AREA MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CASSIAH
Authorized Official - Middle Name:
Authorized Official - Last Name:DEPEW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-887-5683
Mailing Address - Street 1:343 FAIRVIEW DR
Mailing Address - Street 2:UNIT 101
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89701
Mailing Address - Country:US
Mailing Address - Phone:775-887-5683
Mailing Address - Fax:775-887-5677
Practice Address - Street 1:343 FAIRVIEW DR
Practice Address - Street 2:UNIT 101
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89701-5798
Practice Address - Country:US
Practice Address - Phone:775-887-5683
Practice Address - Fax:775-887-5677
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MEDICAL SERVICES OF NEVADA INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-03-12
Last Update Date:2014-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV5921PCS-5253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV9005057011Medicaid