Healthcare Provider Details

I. General information

NPI: 1649900911
Provider Name (Legal Business Name): CONCIERGE PHLEB LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2022
Last Update Date: 09/15/2022
Certification Date: 09/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3430 E FLAMINGO RD
LAS VEGAS NV
89121-5003
US

IV. Provider business mailing address

3430 E FLAMINGO RD
LAS VEGAS NV
89121-5003
US

V. Phone/Fax

Practice location:
  • Phone: 702-852-6570
  • Fax:
Mailing address:
  • Phone: 702-852-6570
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number
License Number State

VIII. Authorized Official

Name: ALBERTO CALDERA
Title or Position: CEO
Credential:
Phone: 702-852-6570