MEDICARE: B&J MEDICAL GROUP 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	251G00000X	Community Based Hospice Care Agency

General Provider Information

NPI Number	:	1669165502
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	B&J MEDICAL GROUP LLC

Provider Business Mailing Address
First Line	:	8860 S MARYLAND PKWY STE 104
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-4005
Country	:	US
Telephone Number	:	702-881-4033
Fax Number	:

Provider Business Practice Location Address
First Line	:	8860 S MARYLAND PKWY STE 104
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-4005
Country	:	US
Telephone Number	:	702-881-4033
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	BILL NASSAR
Credential	:
Telephone Number	:	702-780-4441

Provider Enumeration Date	:	05/26/2023
Last Update Date	:	05/26/2023

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Directions to “B&J MEDICAL GROUP LLC ” Practice Location

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