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General NPI Number Information
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NPI Number | 1316648777
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Entity Type | Organization
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Legal Business Name | OMUC LLC
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Dates
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Enumeration Date | 03/13/2023
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Last Update Date | 08/29/2023
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Provider Practice Location Address
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Address Line | 1501 E CALVADA BLVD
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City | PAHRUMP
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State | NV
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Zip | 89048-5807
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Country | US
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Telephone | 702-302-4569
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Fax |
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Provider Business Mailing Address
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Address Line | 5010 S DECATUR BLVD STE H
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City | LAS VEGAS
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State | NV
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Zip | 89118-4935
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | MRS. MICHELE WARD
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Credential |
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Telephone | 702-302-4569
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207PE0004X
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Taxonomy Name | Emergency Medical Services (Emergency Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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