MEDICARE: VERTECZ

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	282N00000X	General Acute Care Hospital

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1609052612	OTHER	NV	MEDICARE

General Provider Information

NPI Number	:	1497062905
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VERTECZ

Provider Business Mailing Address
First Line	:	8653 DEERING BAY DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89131-1757
Country	:	US
Telephone Number	:	702-480-3562
Fax Number	:	702-363-4769

Provider Business Practice Location Address
First Line	:	8653 DEERING BAY DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89131-1757
Country	:	US
Telephone Number	:	702-480-3562
Fax Number	:	702-363-4769

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JOSEPH G SALAMY
Credential	:	PHD
Telephone Number	:	702-480-3562

Provider Enumeration Date	:	09/03/2010
Last Update Date	:	09/03/2010

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Directions to “VERTECZ ” Practice Location

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