Healthcare Provider Details

I. General information

NPI: 1114426673
Provider Name (Legal Business Name): VMAE CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2018
Last Update Date: 08/25/2020
Certification Date: 08/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2575 MONTESSOURI ST STE 200
LAS VEGAS NV
89117-3060
US

IV. Provider business mailing address

2575 MONTESSOURI ST STE 200
LAS VEGAS NV
89117-3060
US

V. Phone/Fax

Practice location:
  • Phone: 702-485-5020
  • Fax: 702-485-5083
Mailing address:
  • Phone: 702-485-5020
  • Fax: 702-485-5083

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: VIRGINIA M KENDRID
Title or Position: CEO
Credential:
Phone: 702-506-7846