MEDICARE: AM MEDICAL EQUIPMENT

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	332B00000X	Durable Medical Equipment & Medical Supplies	MP00419	NV

General Provider Information

NPI Number	:	1376742866
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AM MEDICAL EQUIPMENT

Provider Business Mailing Address
First Line	:	4110 S MARYLAND PKWY STE 25
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-7505
Country	:	US
Telephone Number	:	702-650-2749
Fax Number	:	702-650-2749

Provider Business Practice Location Address
First Line	:	4110 S MARYLAND PKWY STE 25
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-7505
Country	:	US
Telephone Number	:	702-650-2749
Fax Number	:	702-650-2749

Authorized Official
Title or Position	:	OWNER
Name	:	MR. ARMENAK MANUKYAN
Credential	:
Telephone Number	:	702-650-2749

Provider Enumeration Date	:	07/13/2007
Last Update Date	:	07/13/2007

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