Provider Demographics
NPI:1063592921
Name:NEVADA MEDICAL AND SURGICAL SUPPLY CORP
Entity type:Organization
Organization Name:NEVADA MEDICAL AND SURGICAL SUPPLY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF OPERATIONS/SECRETARY
Authorized Official - Prefix:MS
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:C
Authorized Official - Last Name:PATTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-617-8894
Mailing Address - Street 1:269 CIELITO LINDO ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89012-4828
Mailing Address - Country:US
Mailing Address - Phone:702-617-8894
Mailing Address - Fax:702-617-8846
Practice Address - Street 1:3175 W ALI BABA LN
Practice Address - Street 2:SUITE 802
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89118-1611
Practice Address - Country:US
Practice Address - Phone:702-855-0092
Practice Address - Fax:702-240-9096
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1477506012OtherNPI ENUMERATOR
NV1477506012OtherNPI ENUMERATOR