Casey Professional Health Services Pllc | |
801 E Williams Ave Fallon NV 89406-3052 | |
(702) 453-3799 | |
(702) 453-5741 |
Full Name | Casey Professional Health Services Pllc |
---|---|
Speciality | Hospitalist |
Location | 801 E Williams Ave, Fallon, Nevada |
Authorized Official Name and Position | Amanda Sue Casey (OWNER) |
Authorized Official Contact | 7757504408 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Casey Professional Health Services Pllc 660 W Williams Ave Fallon NV 89406-2739 Ph: (702) 453-3799 | Casey Professional Health Services Pllc 801 E Williams Ave Fallon NV 89406-3052 Ph: (702) 453-3799 |
NPI Number | 1558708644 |
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Provider Enumeration Date | 05/29/2013 |
Last Update Date | 07/11/2024 |
Medicare PECOS PAC ID | 0446491112 |
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Medicare Enrollment ID | O20130722000458 |
Identifier | Type | State | Issuer |
---|---|---|---|
1558708644 | NPI | - | NPPES |
13278 | Other | NV | NV LIC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 13278 (Nevada) | Secondary |
208M00000X | Hospitalist | 13278 (Nevada) | Primary |
Provider Name | Amanda S Casey |
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Provider Type | Practitioner - Hospitalist |
Provider Identifiers | NPI Number: 1497879175 PECOS PAC ID: 1850430158 Enrollment ID: I20091130000169 |
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