MEDICARE: AXIS HEALTHCARE CLINICS

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

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	:	1912579103
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AXIS HEALTHCARE CLINICS

Provider Business Mailing Address
First Line	:	500 N RAINBOW BLVD STE 300
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89107-1061
Country	:	US
Telephone Number	:	702-389-1148
Fax Number	:	702-389-1149

Provider Business Practice Location Address
First Line	:	4375 LAS VEGAS BLVD N STE 9
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89115-0587
Country	:	US
Telephone Number	:	702-410-5510
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF OPERATIONS
Name	:	KRISTA HUEY
Credential	:
Telephone Number	:	702-528-9947

Provider Enumeration Date	:	07/15/2021
Last Update Date	:	07/15/2021

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Directions to “AXIS HEALTHCARE CLINICS ” Practice Location

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