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NPI Code Detail

MEDICARE: LE DARRIUS DAVIS

MEDICARE: LE DARRIUS DAVIS
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
1251E00000XHome Health AgencyNV

General Provider Information

NPI Number : 1285103507
Entity Type Code : Individual
Provider Name (Legal Business Name) : LE DARRIUS DAVIS
Provider Business Mailing Address
First Line : 1517 SANTA ROSALIA DR
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89031-1010
Country : US
Telephone Number : 702-929-3297
Fax Number : 702-750-9927
Provider Business Practice Location Address
First Line : 1517 SANTA ROSALIA DR
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89031-1010
Country : US
Telephone Number : 702-929-3297
Fax Number : 702-750-9927
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2018
Last Update Date : 11/15/2018

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Directions to “ LE DARRIUS DAVIS ” Practice Location

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