MEDICARE: GALLARON GROUP LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WG0000X	General Practice Registered Nurse

General Provider Information

NPI Number	:	1023849890
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GALLARON GROUP LLC

Provider Business Mailing Address
First Line	:	1136 VIA ROCCA
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89052-0520
Country	:	US
Telephone Number	:	702-588-9723
Fax Number	:

Provider Business Practice Location Address
First Line	:	9788 GILESPIE ST STE D-426
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89183-7604
Country	:	US
Telephone Number	:	702-588-9721
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JERRY J GALLARON
Credential	:	NURSE PRACTITIONER
Telephone Number	:	702-588-9723

Provider Enumeration Date	:	08/12/2024
Last Update Date	:	08/12/2024

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Directions to “GALLARON GROUP LLC ” Practice Location

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