MEDICARE: OMS SURGICAL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1023355450
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OMS SURGICAL

Provider Business Mailing Address
First Line	:	7446 BERMUDA ISLAND ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-1173
Country	:	US
Telephone Number	:	702-808-2998
Fax Number	:	866-496-5083

Provider Business Practice Location Address
First Line	:	7446 BERMUDA ISLAND ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-1173
Country	:	US
Telephone Number	:	702-808-2998
Fax Number	:	866-496-5083

Authorized Official
Title or Position	:	PRINCIPLE
Name	:	MR. MANUEL PERALES
Credential	:
Telephone Number	:	702-808-2998

Provider Enumeration Date	:	01/04/2013
Last Update Date	:	01/04/2013

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