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General NPI Number Information
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NPI Number | 1972007169
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Entity Type | Organization
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Legal Business Name | ADVANCED ISOTOPES OF NEVADA, LLC
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Dates
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Enumeration Date | 03/21/2018
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Last Update Date | 03/21/2018
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Provider Practice Location Address
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Address Line | 1771 E FLAMINGO RD STE 121A
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City | LAS VEGAS
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State | NV
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Zip | 89119-0837
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Country | US
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Telephone | 702-476-8600
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Fax | 702-750-1376
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Provider Business Mailing Address
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Address Line | 1771 E FLAMINGO RD STE 121A
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City | LAS VEGAS
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State | NV
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Zip | 89119-0837
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Country | US
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Telephone | 702-476-8600
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Fax | 702-750-1376
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Authorized Official
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Title or Position | CFO - PARTNER
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Name | GREG SPATAFORE
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Credential |
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Telephone | 702-208-6418
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336H0001X
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Taxonomy Name | Home Infusion Therapy Pharmacy
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License Number | PHNU02453
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License Number State | NV
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