MEDICARE: AVM CORP, 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	251E00000X	Home Health Agency	NV20131375146	NV

General Provider Information

NPI Number	:	1992144042
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AVM CORP, LLC

Provider Business Mailing Address
First Line	:	3824 S JONES BLVD STE C
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-2451
Country	:	US
Telephone Number	:	702-816-2277
Fax Number	:

Provider Business Practice Location Address
First Line	:	3824 S JONES BLVD STE C
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-2451
Country	:	US
Telephone Number	:	702-816-2277
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JOSELITO L MOLINA
Credential	:
Telephone Number	:	702-816-2277

Provider Enumeration Date	:	06/21/2013
Last Update Date	:	01/08/2018

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