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NPI 1811587793

NPI 1811587793 : COV CLINIC LLC : LAS VEGAS, NV

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General NPI Number Information
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    NPI Number           |    1811587793
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    Entity Type          |    Organization 
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    Legal Business Name  |    COV CLINIC LLC 
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Dates
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    Enumeration Date     |    01/25/2021
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    Last Update Date     |    01/25/2021
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Provider Practice Location Address
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    Address Line         |    5425 S VALLEY VIEW BLVD 
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    City                 |    LAS VEGAS
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    State                |    NV
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    Zip                  |    89118-2415
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    Country              |    US
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    Telephone            |    516-417-4941
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    5425 S VALLEY VIEW BLVD 
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    City                 |    LAS VEGAS
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    State                |    NV
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    Zip                  |    89118-2415
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    Country              |    US
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    Telephone            |    516-417-4941
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     MUBARAK  SHAH 
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    Credential           |    
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    Telephone            |    516-417-4941
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    261QU0200X
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    Taxonomy Name        |    Urgent Care Clinic/Center
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    License Number       |    
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    License Number State |    
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