MEDICARE: EMY'S MEDICAL, 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	332BX2000X	Oxygen Equipment & Supplies (DME)		NV

General Provider Information

NPI Number	:	1356324123
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMY'S MEDICAL, INC.

Provider Business Mailing Address
First Line	:	6376 W SAHARA AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-3050
Country	:	US
Telephone Number	:	702-364-9113
Fax Number	:	702-364-8322

Provider Business Practice Location Address
First Line	:	6376 W SAHARA AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-3050
Country	:	US
Telephone Number	:	702-364-9113
Fax Number	:	702-364-8322

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. EMELDA UMOH EKPOUDIA
Credential	:	RN
Telephone Number	:	702-364-9113

Provider Enumeration Date	:	11/24/2005
Last Update Date	:	08/22/2020

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