Healthcare Provider Details

I. General information

NPI: 1891253175
Provider Name (Legal Business Name): DIGNITY SELECT NEVADA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2019
Last Update Date: 03/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 CORONADO CENTER DR STE 120
HENDERSON NV
89052-5035
US

IV. Provider business mailing address

4714 GETTYSBURG RD
MECHANICSBURG PA
17055-4325
US

V. Phone/Fax

Practice location:
  • Phone: 702-564-4116
  • Fax: 702-932-2403
Mailing address:
  • Phone: 717-972-1100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: ELIZABETH GELBAUGH
Title or Position: MANAGER
Credential:
Phone: 717-972-1100