MEDICARE: STATE MEDICAL EQUIPMENT LIMITED LIABILITY COMPANY

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)

General Provider Information

NPI Number	:	1366700015
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STATE MEDICAL EQUIPMENT LIMITED LIABILITY COMPANY

Provider Business Mailing Address
First Line	:	3950 E SUNSET RD
Second Line	:	SUITE 112
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-4905
Country	:	US
Telephone Number	:	702-538-9555
Fax Number	:	702-538-8433

Provider Business Practice Location Address
First Line	:	3950 E SUNSET RD
Second Line	:	SUITE 112
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-4905
Country	:	US
Telephone Number	:	702-538-9555
Fax Number	:	702-538-8433

Authorized Official
Title or Position	:	OWNER
Name	:	MISS MAY FLORES CUENCA
Credential	:
Telephone Number	:	702-538-9555

Provider Enumeration Date	:	05/01/2012
Last Update Date	:	09/06/2019

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Directions to “STATE MEDICAL EQUIPMENT LIMITED LIABILITY COMPANY ” Practice Location

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