MEDICARE: NEM-CARE 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	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1750006458
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEM-CARE LLC

Provider Business Mailing Address
First Line	:	1725 S RAINBOW BLVD STE 17
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-2970
Country	:	US
Telephone Number	:	702-473-9600
Fax Number	:	702-473-9966

Provider Business Practice Location Address
First Line	:	1725 S RAINBOW BLVD STE 17
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-2970
Country	:	US
Telephone Number	:	702-473-9600
Fax Number	:	702-473-9966

Authorized Official
Title or Position	:	OWNER
Name	:	EDMOND PATVAKANYAN
Credential	:
Telephone Number	:	702-255-1114

Provider Enumeration Date	:	10/05/2022
Last Update Date	:	10/05/2022

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Directions to “NEM-CARE LLC ” Practice Location

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