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General NPI Number Information
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NPI Number | 1780001347
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Entity Type | Organization
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Legal Business Name | CARELINK MEDICAL GROUP OF NEVADA LLC
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Dates
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Enumeration Date | 03/20/2014
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Last Update Date | 03/20/2014
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Provider Practice Location Address
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Address Line | 320 E WARM SPRINGS RD SUITE 4A UNIT 7
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City | LAS VEGAS
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State | NV
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Zip | 89119-4243
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Country | US
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Telephone | 702-586-0175
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Fax | 702-586-2227
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Provider Business Mailing Address
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Address Line | 320 E WARM SPRINGS RD SUITE 4A UNIT 7
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City | LAS VEGAS
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State | NV
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Zip | 89119-4243
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Country | US
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Telephone | 702-586-0175
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Fax | 702-586-2227
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Authorized Official
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Title or Position | ADMNISTRATOR
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Name | MRS. LILIBETH A MACACHOR
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Credential | RN
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Telephone | 702-586-0175
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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