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NPI Code Detail

MEDICARE: ESSENTIAL MEDICAL SUPPLIES, LLC

MEDICARE: ESSENTIAL MEDICAL SUPPLIES, 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 SuppliesNV

General Provider Information

NPI Number : 1851491864
Entity Type Code : Organization
Provider Name (Legal Business Name) : ESSENTIAL MEDICAL SUPPLIES, 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 : 702-341-1114
Fax Number : 702-364-1114
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 : 702-341-1114
Fax Number : 702-364-1114
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : SUSAN MCKERNAN
Credential :
Telephone Number : 702-885-8612
Provider Enumeration Date : 09/22/2006
Last Update Date : 08/13/2007

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Directions to “ESSENTIAL MEDICAL SUPPLIES, LLC ” Practice Location

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