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NPI Code Detail

MEDICARE: PACIFIC PEDORTHIC SERVICES

MEDICARE: PACIFIC PEDORTHIC SERVICES
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
1332BC3200XCustomized Equipment (DME)
2332BX2000XOxygen Equipment & Supplies (DME)
3332B00000XDurable Medical Equipment & Medical Supplies

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1053528828
Entity Type Code : Organization
Provider Name (Legal Business Name) : PACIFIC PEDORTHIC SERVICES
Provider Business Mailing Address
First Line : 106 S JONES BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89107-2614
Country : US
Telephone Number : 702-629-6818
Fax Number : 702-993-8426
Provider Business Practice Location Address
First Line : 106 S JONES BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89107-2614
Country : US
Telephone Number : 702-629-6818
Fax Number : 702-993-8426
Authorized Official
Title or Position : PRESIDENT
Name : NATHAN HIGHAM
Credential : CPED
Telephone Number : 702-629-6818
Provider Enumeration Date : 05/17/2007
Last Update Date : 03/02/2020

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Directions to “PACIFIC PEDORTHIC SERVICES ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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