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NPI Code Detail

MEDICARE: FIRSTMED OF SOUTHERN NEVADA LLC

MEDICARE: FIRSTMED OF SOUTHERN NEVADA 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
1261QU0200XUrgent Care Clinic/Center1006439285NV

General Provider Information

NPI Number : 1164629804
Entity Type Code : Organization
Provider Name (Legal Business Name) : FIRSTMED OF SOUTHERN NEVADA LLC
Provider Business Mailing Address
First Line : 825 S 7TH ST
Second Line :
City : LAS VEGAS
State : NV
Zip : 89101-6909
Country : US
Telephone Number : 702-474-2460
Fax Number : 702-474-7529
Provider Business Practice Location Address
First Line : 3343 S EASTERN AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89109-3312
Country : US
Telephone Number : 702-474-2460
Fax Number : 702-474-7529
Authorized Official
Title or Position : MEMBER
Name : DR. EMELINA BARTOLOME QUISUMBING
Credential : M.D.
Telephone Number : 702-474-2460
Provider Enumeration Date : 06/27/2007
Last Update Date : 08/06/2007

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Directions to “FIRSTMED OF SOUTHERN NEVADA LLC ” Practice Location

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