MEDICARE: NEVADA CENTER FOR BLOOD DISORDERS

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	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1558796920
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEVADA CENTER FOR BLOOD DISORDERS

Provider Business Mailing Address
First Line	:	4210 STUDIO ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89115-2312
Country	:	US
Telephone Number	:	702-732-1956
Fax Number	:	702-732-3225

Provider Business Practice Location Address
First Line	:	3121 S MARYLAND PKWY STE 206
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89109-2302
Country	:	US
Telephone Number	:	702-732-1956
Fax Number	:	702-732-3225

Authorized Official
Title or Position	:	PRESIDENT
Name	:	LINDA NEILSON
Credential	:
Telephone Number	:	702-426-4000

Provider Enumeration Date	:	09/04/2013
Last Update Date	:	09/04/2013

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