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NPI Code Detail

MEDICARE: DECATUR MEDICAL EQUIPMENT LLC

MEDICARE: DECATUR MEDICAL EQUIPMENT 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 SuppliesMP00535NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MP00535OTHERNVNEVADA STATE BOARD OF PHARMARCY

General Provider Information

NPI Number : 1811132954
Entity Type Code : Organization
Provider Name (Legal Business Name) : DECATUR MEDICAL EQUIPMENT LLC
Provider Business Mailing Address
First Line : 3375 S DECATUR BLVD
Second Line : SUITE 20
City : LAS VEGAS
State : NV
Zip : 89102-8042
Country : US
Telephone Number : 702-220-5827
Fax Number : 702-220-9846
Provider Business Practice Location Address
First Line : 3375 S DECATUR BLVD
Second Line : SUITE 20
City : LAS VEGAS
State : NV
Zip : 89102-8042
Country : US
Telephone Number : 702-220-5827
Fax Number : 702-220-9846
Authorized Official
Title or Position : PRESIDENT
Name : ARMEN AYRAPETYAN
Credential :
Telephone Number : 702-220-5827
Provider Enumeration Date : 12/03/2008
Last Update Date : 12/03/2008

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Directions to “DECATUR MEDICAL EQUIPMENT LLC ” Practice Location

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