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NPI Code Detail

MEDICARE: BIO-MEDICAL APPLICATIONS OF NEVADA, INC.

MEDICARE: BIO-MEDICAL APPLICATIONS OF NEVADA, 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
1261QE0700XEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center

General Provider Information

NPI Number : 1205184801
Entity Type Code : Organization
Provider Name (Legal Business Name) : BIO-MEDICAL APPLICATIONS OF NEVADA, INC.
Provider Business Mailing Address
First Line : 1905 CIVIC CENTER DR
Second Line : SUITE 201
City : NORTH LAS VEGAS
State : NV
Zip : 89030-7143
Country : US
Telephone Number : 702-214-9516
Fax Number : 702-214-9415
Provider Business Practice Location Address
First Line : 1905 CIVIC CENTER DR
Second Line : SUITE 201
City : NORTH LAS VEGAS
State : NV
Zip : 89030-7143
Country : US
Telephone Number : 702-214-9516
Fax Number : 702-214-9415
Authorized Official
Title or Position : VP AND TREASURER
Name : MR. MARK R FAWCETT
Credential :
Telephone Number : 781-699-9000
Provider Enumeration Date : 08/29/2012
Last Update Date : 09/20/2013

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