Healthcare Provider Details

I. General information

NPI: 1922436070
Provider Name (Legal Business Name): MOBILE MEDICAL SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/29/2013
Last Update Date: 10/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2464 MUIRFIELD AVE
HENDERSON NV
89074-4991
US

IV. Provider business mailing address

2464 MUIRFIELD AVE
HENDERSON NV
89074-4991
US

V. Phone/Fax

Practice location:
  • Phone: 702-350-6300
  • Fax:
Mailing address:
  • Phone: 720-350-6300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License NumberNV20131247105
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberNV20131247105
License Number StateNV

VIII. Authorized Official

Name: HOMER SIMS
Title or Position: MEMBER
Credential:
Phone: 702-350-6300