Provider Demographics
NPI:1942400395
Name:PACIFIC HOME HEALTH CARE INC
Entity Type:Organization
Organization Name:PACIFIC HOME HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/VICE-PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BERNADETTE
Authorized Official - Middle Name:D
Authorized Official - Last Name:PINGUE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:702-208-6577
Mailing Address - Street 1:5700 SPRING MOUNTAIN RD
Mailing Address - Street 2:STE M
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-8860
Mailing Address - Country:US
Mailing Address - Phone:702-208-6577
Mailing Address - Fax:702-243-1818
Practice Address - Street 1:5700 SPRING MOUNTAIN RD
Practice Address - Street 2:STE M
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-8860
Practice Address - Country:US
Practice Address - Phone:702-208-6577
Practice Address - Fax:702-243-1818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-24
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4450HHA-0251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV4450HHA-0OtherSTATE OF NEVADA DEPARTMEN