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NPI Code Detail

MEDICARE: 1-800MEDIVAN, INC.

MEDICARE: 1-800MEDIVAN, 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
1343900000XNon-emergency Medical Transport (VAN)

General Provider Information

NPI Number : 1538615208
Entity Type Code : Organization
Provider Name (Legal Business Name) : 1-800MEDIVAN, INC.
Provider Business Mailing Address
First Line : 7260 W AZURE DR
Second Line : #140 STE 2061
City : LAS VEGAS
State : NV
Zip : 89130-7999
Country : US
Telephone Number : 800-633-4826
Fax Number : 702-941-3021
Provider Business Practice Location Address
First Line : 7260 W AZURE DR
Second Line : #140 STE 2061
City : LAS VEGAS
State : NV
Zip : 89130-7999
Country : US
Telephone Number : 800-633-4826
Fax Number : 702-941-3021
Authorized Official
Title or Position : PRESIDENT
Name : YURI HAMBARDZUMYAN
Credential :
Telephone Number : 800-633-4826
Provider Enumeration Date : 08/31/2016
Last Update Date : 08/31/2016

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