MEDICARE: JM & JM 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	207R00000X	Internal Medicine Physician		NV

General Provider Information

NPI Number	:	1386998128
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JM & JM CORP

Provider Business Mailing Address
First Line	:	7240 W AZURE DR
Second Line	:	SUITE 165
City	:	LAS VEGAS
State	:	NV
Zip	:	89130-4404
Country	:	US
Telephone Number	:	702-478-7785
Fax Number	:	702-478-8404

Provider Business Practice Location Address
First Line	:	7240 W AZURE DR
Second Line	:	SUITE 165
City	:	LAS VEGAS
State	:	NV
Zip	:	89130-4404
Country	:	US
Telephone Number	:	702-478-7785
Fax Number	:	702-478-8404

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. JENNY MOYA
Credential	:
Telephone Number	:	702-478-7785

Provider Enumeration Date	:	11/01/2012
Last Update Date	:	03/04/2013

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Directions to “JM & JM CORP ” Practice Location

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