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General NPI Number Information
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NPI Number | 1144978156
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Entity Type | Organization
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Legal Business Name | AVID MEDICAL SUPPLY INC
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Dates
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Enumeration Date | 03/17/2022
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Last Update Date | 03/18/2022
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Provider Practice Location Address
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Address Line | 64 N PECOS RD STE 600
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City | HENDERSON
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State | NV
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Zip | 89074-7354
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Country | US
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Telephone | 800-282-3166
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Fax | 725-218-3446
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Provider Business Mailing Address
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Address Line | 64 N PECOS RD STE 600
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City | HENDERSON
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State | NV
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Zip | 89074-7354
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Country | US
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Telephone | 800-282-3166
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Fax | 725-218-3446
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Authorized Official
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Title or Position | SECRETARY
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Name | ANGEL VASQUEZ
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Credential |
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Telephone | 800-282-3166
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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