Provider Demographics
NPI:1770353328
Name:UNIMED HOME HEALTH LLC
Entity type:Organization
Organization Name:UNIMED HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:OSCAR JAY
Authorized Official - Middle Name:
Authorized Official - Last Name:BUSTAMANTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-722-7609
Mailing Address - Street 1:6272 SPRING MOUNTAIN RD STE 105
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-8876
Mailing Address - Country:US
Mailing Address - Phone:702-769-8833
Mailing Address - Fax:702-748-8326
Practice Address - Street 1:6272 SPRING MOUNTAIN RD STE 105
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-8876
Practice Address - Country:US
Practice Address - Phone:702-769-8833
Practice Address - Fax:702-748-8326
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-04
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health