MEDICARE: PRIMARY CARE SOLUTIONS OF NEVADA, 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	207R00000X	Internal Medicine Physician
2	208D00000X	General Practice Physician

General Provider Information

NPI Number	:	1942068101
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRIMARY CARE SOLUTIONS OF NEVADA, LLC

Provider Business Mailing Address
First Line	:	9550 S EASTERN AVE STE 248
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-8041
Country	:	US
Telephone Number	:	702-487-2613
Fax Number	:

Provider Business Practice Location Address
First Line	:	9550 S EASTERN AVE STE 248
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-8041
Country	:	US
Telephone Number	:	702-487-2613
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MATTHEW SCOTT
Credential	:
Telephone Number	:	702-487-2613

Provider Enumeration Date	:	03/11/2024
Last Update Date	:	03/11/2024

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