Healthcare Provider Details

I. General information

NPI: 1811120884
Provider Name (Legal Business Name): METATE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2009
Last Update Date: 08/25/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

540 MARKS ST
HENDERSON NV
89014-6654
US

IV. Provider business mailing address

2349 ROSENDALE VILLAGE AVE
HENDERSON NV
89052-8731
US

V. Phone/Fax

Practice location:
  • Phone: 702-898-7315
  • Fax: 702-898-7835
Mailing address:
  • Phone: 702-363-8524
  • Fax: 702-363-8524

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number204
License Number StateNV

VIII. Authorized Official

Name: MR. ERNEST LEE SCHWENDEMANN
Title or Position: MANAGING MEMBER
Credential: BC-HIS
Phone: 702-898-7315