Healthcare Provider Details

I. General information

NPI: 1053316810
Provider Name (Legal Business Name): APM MEDICAL SUPPLIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2005
Last Update Date: 03/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5025 S EASTERN AVE SUITE 4
LAS VEGAS NV
89119-2318
US

IV. Provider business mailing address

5025 S EASTERN AVE SUITE 4
LAS VEGAS NV
89119-2318
US

V. Phone/Fax

Practice location:
  • Phone: 702-259-0374
  • Fax: 702-259-4729
Mailing address:
  • Phone: 702-259-0374
  • Fax: 702-259-4729

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MRS. AMANDA LEA DENTO
Title or Position: PRESIDENT
Credential:
Phone: 469-939-6116