| Community Network Health Services, Llc | |
|
3670 N Rancho Dr Ste 105 Las Vegas NV 89130-3192 | |
| (702) 432-6463 | |
| (702) 432-6464 |
| Full Name | Community Network Health Services, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3670 N Rancho Dr Ste 105, Las Vegas, Nevada |
| Authorized Official Name and Position | Tami V Bass (ADMINISTRATOR) |
| Authorized Official Contact | 7025913055 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Network Health Services, Llc 3670 N Rancho Dr Ste 105 Las Vegas NV 89130-3192 Ph: (702) 432-6463 | Community Network Health Services, Llc 3670 N Rancho Dr Ste 105 Las Vegas NV 89130-3192 Ph: (702) 432-6463 |
| NPI Number | 1336731686 |
|---|---|
| Provider Enumeration Date | 02/08/2021 |
| Last Update Date | 02/08/2021 |
| Certification Date | 02/08/2021 |
| Medicare PECOS PAC ID | 9335539386 |
|---|---|
| Medicare Enrollment ID | O20211206001281 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336731686 | NPI | - | NPPES |
| Provider Name | Mariliza Ilagan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114316320 PECOS PAC ID: 1254636970 Enrollment ID: I20170616001406 |
| Provider Name | Henry M Rucker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407392855 PECOS PAC ID: 2062780042 Enrollment ID: I20180814003849 |
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