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General NPI Number Information
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NPI Number | 1396054169
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Entity Type | Organization
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Legal Business Name | FIRSTMED HEALTH AND WELLNESS CENTER INC
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Dates
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Enumeration Date | 09/28/2010
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Last Update Date | 09/03/2024
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Provider Practice Location Address
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Address Line | 3343 S EASTERN AVE
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City | LAS VEGAS
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State | NV
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Zip | 89169-3312
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Country | US
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Telephone | 702-731-0909
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Fax | 702-731-1020
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Provider Business Mailing Address
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Address Line | 8936 SPANISH RIDGE AVE
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City | LAS VEGAS
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State | NV
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Zip | 89148-1354
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Country | US
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Telephone | 702-731-0909
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Fax | 702-998-2991
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Authorized Official
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Title or Position | CEO
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Name | MS. ANGELA QUINN
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Credential | CEO
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Telephone | 702-731-0909
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal 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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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