MEDICARE: CARELINK MEDICAL GROUP OF NEVADA 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	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1780001347
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARELINK MEDICAL GROUP OF NEVADA LLC

Provider Business Mailing Address
First Line	:	320 E WARM SPRINGS RD
Second Line	:	SUITE 4A UNIT 7
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-4243
Country	:	US
Telephone Number	:	702-586-0175
Fax Number	:	702-586-2227

Provider Business Practice Location Address
First Line	:	320 E WARM SPRINGS RD
Second Line	:	SUITE 4A UNIT 7
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-4243
Country	:	US
Telephone Number	:	702-586-0175
Fax Number	:	702-586-2227

Authorized Official
Title or Position	:	ADMNISTRATOR
Name	:	MRS. LILIBETH A MACACHOR
Credential	:	RN
Telephone Number	:	702-586-0175

Provider Enumeration Date	:	03/20/2014
Last Update Date	:	03/20/2014

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