MEDICARE: JOY MOBILITY & MEDICAL SUPPLIES, INC.

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	332B00000X	Durable Medical Equipment & Medical Supplies	MP00407	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1912167149
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOY MOBILITY & MEDICAL SUPPLIES, INC.

Provider Business Mailing Address
First Line	:	6045 S. RAINBOW BLVD
Second Line	:	SUITE 102
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-2572
Country	:	US
Telephone Number	:	702-434-2458
Fax Number	:	702-434-7072

Provider Business Practice Location Address
First Line	:	6045 S. RAINBOW BLVD
Second Line	:	SUITE 102
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-2572
Country	:	US
Telephone Number	:	702-434-2458
Fax Number	:	702-434-7072

Authorized Official
Title or Position	:	MANAGER
Name	:	MRS. ISIDORA DE GUZMAN TAGUD
Credential	:
Telephone Number	:	702-434-2458

Provider Enumeration Date	:	06/11/2008
Last Update Date	:	03/06/2009

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