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NPI Code Detail

MEDICARE: LIFELINK MEDICAL SUPPLY LLC

MEDICARE: LIFELINK MEDICAL 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
1332B00000XDurable Medical Equipment & Medical Supplies

General Provider Information

NPI Number : 1700728854
Entity Type Code : Organization
Provider Name (Legal Business Name) : LIFELINK MEDICAL SUPPLY LLC
Provider Business Mailing Address
First Line : 675 N NELLIS BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89110-5383
Country : US
Telephone Number : 702-971-5703
Fax Number :
Provider Business Practice Location Address
First Line : 675 N NELLIS BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89110-5383
Country : US
Telephone Number : 702-971-5703
Fax Number :
Authorized Official
Title or Position : OWNER
Name : LEDOR NWIBIABU
Credential :
Telephone Number : 702-848-8455
Provider Enumeration Date : 04/07/2026
Last Update Date : 04/07/2026

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Directions to “LIFELINK MEDICAL SUPPLY LLC ” Practice Location

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