Healthcare Provider Details

I. General information

NPI: 1417340902
Provider Name (Legal Business Name): APT LV LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2015
Last Update Date: 03/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1661 E FLAMINGO RD SUITE 6
LAS VEGAS NV
89119-5291
US

IV. Provider business mailing address

1661 E FLAMINGO RD STE 6
LAS VEGAS NV
89119-5291
US

V. Phone/Fax

Practice location:
  • Phone: 702-850-2786
  • Fax: 702-850-2794
Mailing address:
  • Phone: 702-850-2786
  • Fax: 702-850-2794

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: EDWARD C GOOD
Title or Position: OWNER
Credential:
Phone: 214-347-7140