Provider Demographics
NPI:1982692349
Name:SIERRA HOME MEDICAL PRODUCTS, INC
Entity Type:Organization
Organization Name:SIERRA HOME MEDICAL PRODUCTS, INC
Other - Org Name:SOUTHWEST MEDICAL PHARMACY & HME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:REGIONAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTILLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-480-2550
Mailing Address - Street 1:6720 PLACID ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-3541
Mailing Address - Country:US
Mailing Address - Phone:702-796-1016
Mailing Address - Fax:702-792-4097
Practice Address - Street 1:6720 PLACID ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-3541
Practice Address - Country:US
Practice Address - Phone:702-796-1016
Practice Address - Fax:702-792-4097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-10
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV479451180332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV003302996Medicaid
NV1209800001Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER