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General NPI Number Information
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NPI Number | 1861717084
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Entity Type | Organization
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Legal Business Name | NEVADA CHOICE MED INC
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Dates
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Enumeration Date | 03/30/2010
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Last Update Date | 03/30/2010
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Provider Practice Location Address
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Address Line | 2950 S MARYLAND PKWY
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City | LAS VEGAS
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State | NV
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Zip | 89109-2204
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Country | US
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Telephone | 702-524-9149
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Fax |
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Provider Business Mailing Address
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Address Line | 4075 S DURANGO DR STE 111
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City | LAS VEGAS
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State | NV
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Zip | 89147-4163
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Country | US
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Telephone | 702-524-9149
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | FRED J UHRLE JR.
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Credential | M.D.
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Telephone | 702-524-1979
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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 | 29D1035509
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License Number State | NV
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