MEDICARE: INTENSIVE CARE INC

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	291U00000X	Clinical Medical Laboratory	29D0537879	NV

General Provider Information

NPI Number	:	1194040899
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTENSIVE CARE INC

Provider Business Mailing Address
First Line	:	4012 S RAINBOW BLVD
Second Line	:	STE K 320
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-2010
Country	:	US
Telephone Number	:	702-534-5214
Fax Number	:

Provider Business Practice Location Address
First Line	:	3012 S DURANGO DR
Second Line	:	STE 1
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-9186
Country	:	US
Telephone Number	:	702-534-5214
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	NELLI TOVMASYAN
Credential	:
Telephone Number	:	702-534-7214

Provider Enumeration Date	:	04/06/2010
Last Update Date	:	04/06/2010

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Directions to “INTENSIVE CARE INC ” Practice Location

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