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NPI Code Detail

MEDICARE: FIRSTMED HEALTH AND WELLNESS CENTER INC

MEDICARE: FIRSTMED HEALTH AND WELLNESS CENTER INC
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
1207R00000XInternal Medicine Physician
2363LF0000XFamily Nurse Practitioner
3261QF0400XFederally Qualified Health Center (FQHC)

General Provider Information

NPI Number : 1396054169
Entity Type Code : Organization
Provider Name (Legal Business Name) : FIRSTMED HEALTH AND WELLNESS CENTER INC
Provider Business Mailing Address
First Line : 8936 SPANISH RIDGE AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89148-1354
Country : US
Telephone Number : 702-731-0909
Fax Number : 702-998-2991
Provider Business Practice Location Address
First Line : 3343 S EASTERN AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89169-3312
Country : US
Telephone Number : 702-731-0909
Fax Number : 702-731-1020
Authorized Official
Title or Position : CEO
Name : MS. ANGELA QUINN
Credential : CEO
Telephone Number : 702-731-0909
Provider Enumeration Date : 09/28/2010
Last Update Date : 09/03/2024

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Directions to “FIRSTMED HEALTH AND WELLNESS CENTER INC ” Practice Location

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