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NPI Code Detail

MEDICARE: WEST LAS VEGAS PUBLIC SCHOOLS

MEDICARE: WEST LAS VEGAS PUBLIC SCHOOLS
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
1261QS1000XStudent Health Clinic/Center

General Provider Information

NPI Number : 1720305188
Entity Type Code : Organization
Provider Name (Legal Business Name) : WEST LAS VEGAS PUBLIC SCHOOLS
Provider Business Mailing Address
First Line : 179 BRIDGE ST
Second Line :
City : LAS VEGAS
State : NM
Zip : 87701-3495
Country : US
Telephone Number : 505-426-2564
Fax Number : 505-426-2579
Provider Business Practice Location Address
First Line : 1024 SOUTH PACIFIC
Second Line :
City : LAS VEGAS
State : NM
Zip : 87701-3495
Country : US
Telephone Number : 505-426-2564
Fax Number : 505-426-2579
Authorized Official
Title or Position : CLINIC COORDINATOR
Name : MRS. YOLANDA CARRILLO
Credential :
Telephone Number : 505-426-2564
Provider Enumeration Date : 04/26/2010
Last Update Date : 04/26/2010

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Directions to “WEST LAS VEGAS PUBLIC SCHOOLS ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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