Healthcare Provider Details

I. General information

NPI: 1659377281
Provider Name (Legal Business Name): CESAR A GALINDO SR. SUPPLIER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/28/2005
Last Update Date: 09/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1924 E SAHARA AVE
LAS VEGAS NV
89104-3843
US

IV. Provider business mailing address

1924 E SAHARA AVE
LAS VEGAS NV
89104-3843
US

V. Phone/Fax

Practice location:
  • Phone: 702-457-5485
  • Fax: 702-457-5516
Mailing address:
  • Phone: 702-457-5485
  • Fax: 702-457-5516

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License NumberMP00099
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number2439
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: