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General NPI Number Information
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NPI Number | 1699986547
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Entity Type | Organization
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Legal Business Name | L.V. MEDICAL SUPPLY
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Dates
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Enumeration Date | 05/24/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 4375 N.LAS VEGAS BLV #6 #6
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City | LAS VEGAS
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State | NV
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Zip | 89115
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Country | US
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Telephone | 702-643-2948
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Fax |
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Provider Business Mailing Address
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Address Line | 4375 LAS VEGAS BLVD N STE 6
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City | LAS VEGAS
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State | NV
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Zip | 89115-0587
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Country | US
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Telephone | 702-643-2648
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Fax | 702-643-2568
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Authorized Official
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Title or Position | OWNER
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Name | OLEXIY KORSHUN
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Credential |
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Telephone | 702-643-2548
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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 | NV
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