MEDICARE: CHRIS MAGLARAS JR.

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	2000027-424	NV

General Provider Information

NPI Number	:	1457663627
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRIS MAGLARAS JR.

Provider Business Mailing Address
First Line	:	2550 E DESERT INN RD
Second Line	:	#278
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-3611
Country	:	US
Telephone Number	:	702-340-1144
Fax Number	:	702-215-6395

Provider Business Practice Location Address
First Line	:	4863 MONTERREY AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-6812
Country	:	US
Telephone Number	:	702-340-1144
Fax Number	:	702-215-6395

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/05/2010
Last Update Date	:	07/05/2010

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