| 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 1250 Manchester Cir Fallon NV 89406-3523 Ph: (775) 750-4408 | Casey Professional Health Services Pllc 801 E Williams Ave Fallon NV 89406-3052 Ph: (702) 453-3799 |
| NPI Number | 1558708644 |
|---|---|
| Provider Enumeration Date | 05/29/2013 |
| Last Update Date | 07/08/2019 |
| Medicare PECOS PAC ID | 0446491112 |
|---|---|
| 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 |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1497879175 PECOS PAC ID: 1850430158 Enrollment ID: I20091130000169 |
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