MEDICARE: ISU 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
1	332B00000X	Durable Medical Equipment & Medical Supplies	MP00286	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	5407420001	OTHER	NV	DMEPOS

General Provider Information

NPI Number	:	1689752081
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ISU INC.

Provider Business Mailing Address
First Line	:	1745 N NELLIS BLVD STE C
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89115-3673
Country	:	US
Telephone Number	:	702-459-7500
Fax Number	:	702-459-1176

Provider Business Practice Location Address
First Line	:	1745 N NELLIS BLVD STE C
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89115-3673
Country	:	US
Telephone Number	:	702-459-7500
Fax Number	:	702-459-1176

Authorized Official
Title or Position	:	PRESIDENT/ CEO
Name	:	DR. CHUKA HUMPHREY EJIOFOR
Credential	:	PH.D
Telephone Number	:	702-459-7500

Provider Enumeration Date	:	11/02/2006
Last Update Date	:	12/21/2009

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Directions to “ISU INC. ” Practice Location

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