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NPI Code Detail

MEDICARE: 21ST CENTURY MOVES LLC

MEDICARE: 21ST CENTURY MOVES 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
1305S00000XPoint of ServiceNV20151563054NV

General Provider Information

NPI Number : 1093186553
Entity Type Code : Organization
Provider Name (Legal Business Name) : 21ST CENTURY MOVES LLC
Provider Business Mailing Address
First Line : 245 E CENTENNIAL PKWY # 23-3116
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89084-1354
Country : US
Telephone Number : 949-445-3307
Fax Number :
Provider Business Practice Location Address
First Line : 245 E CENTENNIAL PKWY # 23-3116
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89084-1354
Country : US
Telephone Number : 949-445-3307
Fax Number :
Authorized Official
Title or Position : FOUNDER & MANAGING MEMBER
Name : RO BROOKS
Credential :
Telephone Number : 949-445-3307
Provider Enumeration Date : 10/09/2015
Last Update Date : 06/11/2016

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Directions to “21ST CENTURY MOVES LLC ” Practice Location

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