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General NPI Number Information
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NPI Number | 1184931768
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Entity Type | Organization
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Legal Business Name | VAN GORDER & ASSOCIATES, INC.
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Dates
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Enumeration Date | 09/02/2010
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Last Update Date | 09/02/2010
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Provider Practice Location Address
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Address Line | 2470 N DECATUR BLVD SUITE 115
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City | LAS VEGAS
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State | NV
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Zip | 89108-2981
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Country | US
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Telephone | 702-869-8300
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Fax | 702-221-8308
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Provider Business Mailing Address
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Address Line | 2470 N DECATUR BLVD SUITE 115
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City | LAS VEGAS
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State | NV
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Zip | 89108-2981
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Country | US
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Telephone | 702-869-8300
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Fax | 702-221-8308
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. LINDA JEAN VAN GORDER
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Credential |
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Telephone | 702-869-8300
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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 | NV20031517022
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License Number State | NV
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