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6161 W Charleston Blvd Las Vegas NV 89146-1126 | |
| (702) 486-6000 | |
| (702) 486-8077 |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 6161 W Charleston Blvd, Las Vegas, Nevada |
| Authorized Official Name and Position | Margaret Moe (RATES & COST CONTAINMENT MANAGER) |
| Authorized Official Contact | 7756845990 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
4150 Technology Way Ste:300 Carson City NV 89706-2026 Ph: (775) 684-4051 | 6161 W Charleston Blvd Las Vegas NV 89146-1126 Ph: (702) 486-6000 |
| NPI Number | 1891756920 |
|---|---|
| Provider Enumeration Date | 03/29/2006 |
| Last Update Date | 05/17/2022 |
| Certification Date | 05/17/2022 |
| Medicare PECOS PAC ID | 9234022153 |
|---|---|
| Medicare Enrollment ID | O20100816001116 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891756920 | NPI | - | NPPES |
| 2052189 | Other | PK |
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