Healthcare Provider Details

I. General information

NPI: 1578271011
Provider Name (Legal Business Name): MEHADER TEFERI RESPIRATORY CARE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2022
Last Update Date: 11/14/2022
Certification Date: 11/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6900 N PECOS RD
N LAS VEGAS NV
89086-4400
US

IV. Provider business mailing address

5457 WHITE BARN CT
N LAS VEGAS NV
89081-3508
US

V. Phone/Fax

Practice location:
  • Phone: 702-791-9000
  • Fax: 702-791-9314
Mailing address:
  • Phone: 720-281-6731
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2279C0205X
TaxonomyCritical Care Registered Respiratory Therapist
License NumberRC3371
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: