MEDICARE: MOBILE MEDICAL NOW, 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
1	261QR0208X	Mobile Radiology Clinic/Center

General Provider Information

NPI Number	:	1770875262
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOBILE MEDICAL NOW, LLC

Provider Business Mailing Address
First Line	:	5538 DUNCAN DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89130-2812
Country	:	US
Telephone Number	:	702-744-7111
Fax Number	:	888-809-4647

Provider Business Practice Location Address
First Line	:	3634 N RANCHO DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89130-3149
Country	:	US
Telephone Number	:	702-744-7111
Fax Number	:	888-809-4647

Authorized Official
Title or Position	:	CFO
Name	:	ABBY GROSSA
Credential	:
Telephone Number	:	702-939-6559

Provider Enumeration Date	:	05/03/2011
Last Update Date	:	05/03/2011

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