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NPI Code Detail

MEDICARE: RANDY ROSS FARR

MEDICARE: RANDY ROSS FARR
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
1146L00000XParamedic101677NV

General Provider Information

NPI Number : 1528606985
Entity Type Code : Individual
Provider Name (Legal Business Name) : RANDY ROSS FARR
Provider Business Mailing Address
First Line : 500 N CASINO CENTER BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89101-2944
Country : US
Telephone Number : 702-229-0310
Fax Number :
Provider Business Practice Location Address
First Line : 500 N CASINO CENTER BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89101-2944
Country : US
Telephone Number : 702-229-0310
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/17/2019
Last Update Date : 12/17/2019

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