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General NPI Number Information
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NPI Number | 1578064002
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Entity Type | Organization
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Legal Business Name | OPTIMUMEDICINE LLC
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Dates
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Enumeration Date | 02/21/2018
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 175 E RENO AVE STE C9
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City | LAS VEGAS
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State | NV
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Zip | 89119-1102
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Country | US
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Telephone | 844-888-8911
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Fax | 702-435-7693
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Provider Business Mailing Address
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Address Line | PO BOX 93056
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City | LAS VEGAS
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State | NV
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Zip | 89193-3056
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Country | US
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Telephone | 844-888-8911
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Fax | 702-435-7693
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Authorized Official
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Title or Position | CEO
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Name | DEVON K. EISMA
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Credential |
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Telephone | 702-286-6490
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416A0800X
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Taxonomy Name | Air Ambulance
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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 | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number |
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License Number State | NV
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