MEDICARE: CLARK COUNTY MEDICAL TRANSPORT 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	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1114809944
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLARK COUNTY MEDICAL TRANSPORT LLC

Provider Business Mailing Address
First Line	:	3601 W SAHARA AVE STE 201
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-5821
Country	:	US
Telephone Number	:	725-251-3523
Fax Number	:	725-214-1171

Provider Business Practice Location Address
First Line	:	3601 W SAHARA AVE STE 201
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-5821
Country	:	US
Telephone Number	:	725-251-3523
Fax Number	:	725-214-1171

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	MARIA JILL BUENA ALFONSO
Credential	:
Telephone Number	:	725-255-7865

Provider Enumeration Date	:	07/23/2025
Last Update Date	:	07/23/2025

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Directions to “CLARK COUNTY MEDICAL TRANSPORT LLC ” Practice Location

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