MEDICARE: SET4LIFE,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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1912286675
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SET4LIFE,LLC

Provider Business Mailing Address
First Line	:	8605 MIRADA DEL SOL DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128
Country	:	US
Telephone Number	:	702-363-4684
Fax Number	:	702-363-4684

Provider Business Practice Location Address
First Line	:	8605 MIRADA DEL SOL DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-8207
Country	:	US
Telephone Number	:	702-363-4684
Fax Number	:	702-363-4684

Authorized Official
Title or Position	:	CEO
Name	:	CHARLOTTE P PIDGEON
Credential	:	MBA
Telephone Number	:	702-363-4684

Provider Enumeration Date	:	08/12/2011
Last Update Date	:	03/19/2012

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