Healthcare Provider Details
I. General information
NPI: 1598690901
Provider Name (Legal Business Name): KMED REVENUE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1516 E TROPICANA AVE STE 105
LAS VEGAS NV
89119-6526
US
IV. Provider business mailing address
1516 E TROPICANA AVE STE 105
LAS VEGAS NV
89119-6526
US
V. Phone/Fax
- Phone: 725-977-4399
- Fax: 725-977-4399
- Phone: 725-977-4399
- Fax: 725-977-4399
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MOINUDDIN
SYED
Title or Position: CEO
Credential:
Phone: 725-977-4399