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General NPI Number Information
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NPI Number | 1447839527
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Entity Type | Organization
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Legal Business Name | MONIQUE WADE INTERNATIONAL LLC
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Dates
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Enumeration Date | 04/06/2021
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Last Update Date | 04/06/2021
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Provider Practice Location Address
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Address Line | 5550 PAINTED MIRAGE RD STE 320
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City | LAS VEGAS
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State | NV
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Zip | 89149-4584
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Country | US
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Telephone | 877-279-5757
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Fax | 877-485-0601
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Provider Business Mailing Address
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Address Line | 5550 PAINTED MIRAGE RD STE 320 A064
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City | LAS VEGAS
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State | NV
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Zip | 89149-4584
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Country | US
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Telephone | 877-279-5757
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Fax | 877-485-0601
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Authorized Official
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Title or Position | OWNER
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Name | MONIQUE WADE
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Credential |
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Telephone | 877-279-5757
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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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