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NPI Code Detail

MEDICARE: MEDELITE CAPITAL, LLC

MEDICARE: MEDELITE CAPITAL, LLC
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
1332B00000XDurable Medical Equipment & Medical Supplies

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1E0183282018-6OTHERNVENTITY NUMBER

General Provider Information

NPI Number : 1568016855
Entity Type Code : Organization
Provider Name (Legal Business Name) : MEDELITE CAPITAL, LLC
Provider Business Mailing Address
First Line : 5528 S FORT APACHE RD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89148-7657
Country : US
Telephone Number : 702-960-5760
Fax Number : 702-792-8639
Provider Business Practice Location Address
First Line : 5528 S FORT APACHE RD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89148-7657
Country : US
Telephone Number : 702-960-5760
Fax Number : 702-792-8639
Authorized Official
Title or Position : OWNER
Name : CHRISTOPHER STEPHEN KELLY
Credential :
Telephone Number : 702-960-5760
Provider Enumeration Date : 07/25/2019
Last Update Date : 07/25/2019

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Directions to “MEDELITE CAPITAL, LLC ” Practice Location

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