MEDICARE: EINSTEIN EQUIPMENT LLC

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	NV20131357790	NV

General Provider Information

NPI Number	:	1033543384
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EINSTEIN EQUIPMENT LLC

Provider Business Mailing Address
First Line	:	200 E HORIZON DR
Second Line	:	SUITE B
City	:	HENDERSON
State	:	NV
Zip	:	89015-8033
Country	:	US
Telephone Number	:	702-568-8450
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 E HORIZON DR
Second Line	:	SUITE B
City	:	HENDERSON
State	:	NV
Zip	:	89015-8033
Country	:	US
Telephone Number	:	702-568-8450
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ISRAEL VILLASENOR
Credential	:	D.C.
Telephone Number	:	702-568-8450

Provider Enumeration Date	:	08/22/2013
Last Update Date	:	08/22/2013

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