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Organization

COMMUNITY CARE HEALTH PLAN OF NEVADA, INC.

Active
Other names
Anthem Blue Cross and Blue Shield Healthcare Solutions, AMERIGROUP Nevada, Inc.
Organization subpart
No

Provider details

NPI number
Authorized official
LISA J BOGARD (PRESIDENT AND CEO)
(702) 545-9842
Entity
Organization

Contact information

Practice address
9133 WEST RUSSELL ROAD, BUILDING 9, LAS VEGAS, NV 89148-8351
(702) 545-9842
(702) 360-0755
Mailing address
9133 WEST RUSSELL ROAD, BUILDING 9, LAS VEGAS, NV 89148-8351
(702) 545-9842
(702) 360-0755

Taxonomy

Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
17690
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
100515749
MEDICAID - SOUTH
NV
01
100515750
MEDICAID - NORTH
NV
05
17690
NV
Enumeration date
10/03/2008
Last updated
05/17/2021
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