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General NPI Number Information
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NPI Number | 1053139824
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Entity Type | Organization
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Legal Business Name | 1-800MEDIVAN NV, INC.
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Dates
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Enumeration Date | 10/01/2024
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Last Update Date | 10/01/2024
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Provider Practice Location Address
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Address Line | 6628 SKY POINTE DR STE 129-1402
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City | LAS VEGAS
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State | NV
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Zip | 89131-4070
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Country | US
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Telephone | 800-633-4826
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Fax | 702-941-3021
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Provider Business Mailing Address
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Address Line | 6628 SKY POINTE DR STE 129-1402
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City | LAS VEGAS
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State | NV
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Zip | 89131-4070
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Country | US
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Telephone | 800-633-4826
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Fax | 702-941-3021
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Authorized Official
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Title or Position | PRESIDENT
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Name | YURI HAMBARDZUMYAN
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Credential |
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Telephone | 800-633-4826
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 347E00000X
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Taxonomy Name | Transportation Broker
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License Number |
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License Number State |
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