Provider Demographics
NPI:1427707314
Name:WEKARE MEDICAL CENTER LLC
Entity type:Organization
Organization Name:WEKARE MEDICAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:
Authorized Official - Last Name:BLEDSOE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:725-577-8636
Mailing Address - Street 1:9165 DESIRABLE CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89149-3068
Mailing Address - Country:US
Mailing Address - Phone:725-577-8636
Mailing Address - Fax:
Practice Address - Street 1:3930 E PATRICK LN
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-4924
Practice Address - Country:US
Practice Address - Phone:725-577-8636
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WEKARE MEDICAL CENTER LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-03-20
Last Update Date:2022-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty