MEDICARE: VEGAS MEDICAL SUPPLIES CORP.

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	332BX2000X	Oxygen Equipment & Supplies (DME)	2000134-424	NV

General Provider Information

NPI Number	:	1265602296
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VEGAS MEDICAL SUPPLIES CORP.

Provider Business Mailing Address
First Line	:	3111 S VALLEY VIEW BLVD
Second Line	:	STE A-105
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-8317
Country	:	US
Telephone Number	:	702-638-7900
Fax Number	:	702-638-7901

Provider Business Practice Location Address
First Line	:	3111 S VALLEY VIEW BLVD
Second Line	:	STE A-105
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-8317
Country	:	US
Telephone Number	:	702-638-7900
Fax Number	:	702-638-7901

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. VISHAL MATHUR
Credential	:
Telephone Number	:	702-638-7900

Provider Enumeration Date	:	03/05/2008
Last Update Date	:	04/20/2009

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