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General NPI Number Information
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NPI Number | 1831625383
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Entity Type | Organization
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Legal Business Name | FALCON VENTURES LLC
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Dates
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Enumeration Date | 05/03/2017
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Last Update Date | 05/03/2017
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Provider Practice Location Address
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Address Line | 7695 DESPERADO ST
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City | LAS VEGAS
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State | NV
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Zip | 89131-3346
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Country | US
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Telephone | 908-256-9583
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Fax |
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Provider Business Mailing Address
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Address Line | 7695 DESPERADO ST
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City | LAS VEGAS
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State | NV
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Zip | 89131-3346
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Country | US
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Telephone | 908-256-9583
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. PAUL SENDRO
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Credential |
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Telephone | 908-256-9583
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | E0449642014-7
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License Number State | NV
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