MEDICARE: COMPLETE MEDICAL EQUIPMENT AND SUPPLY LLC

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

General Provider Information

NPI Number	:	1558091512
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPLETE MEDICAL EQUIPMENT AND SUPPLY LLC

Provider Business Mailing Address
First Line	:	200 HOOVER AVE UNIT 903
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89101-6875
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 HOOVER AVE UNIT 903
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89101-6875
Country	:	US
Telephone Number	:	800-478-7132
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	MATT MCWILLIAM
Credential	:
Telephone Number	:	800-478-7132

Provider Enumeration Date	:	06/13/2022
Last Update Date	:	07/12/2022

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