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General NPI Number Information
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NPI Number | 1831451434
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Entity Type | Organization
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Legal Business Name | NATIONAL MEDICAL SOURCE LLC
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Dates
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Enumeration Date | 06/11/2012
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Last Update Date | 12/14/2012
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Provider Practice Location Address
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Address Line | 3790 PARADISE RD #125
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City | LAS VEGAS
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State | NV
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Zip | 89169-5930
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Country | US
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Telephone | 702-302-4142
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Fax | 888-557-7931
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Provider Business Mailing Address
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Address Line | 1350 E FLAMINGO RD # 3227
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City | LAS VEGAS
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State | NV
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Zip | 89119-5263
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Country | US
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Telephone | 702-302-4142
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Fax | 888-557-7931
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. THOMAS MCKEOWN JR.
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Credential |
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Telephone | 702-302-4142
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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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