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General NPI Number Information
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NPI Number | 1902329469
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Entity Type | Organization
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Legal Business Name | MEDALLUS & VACHAROTHONE LTD
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Dates
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Enumeration Date | 07/17/2017
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Last Update Date | 06/16/2025
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Provider Practice Location Address
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Address Line | 1501 LAMOILLE HWY
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City | ELKO
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State | NV
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Zip | 89801-4321
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Country | US
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Telephone | 775-400-1510
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Fax | 775-376-9578
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Provider Business Mailing Address
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Address Line | 10433 S REDWOOD RD STE 2
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City | SOUTH JORDAN
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State | UT
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Zip | 84095-8502
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Country | US
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Telephone | 801-260-1919
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Fax | 801-260-1441
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Authorized Official
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Title or Position | COMPLIANCE ADMIN ASST/ CRED LIAISON
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Name | MONIQUE ARAGON
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Credential |
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Telephone | 801-260-1919
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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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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