Provider Demographics
NPI:1588363493
Name:RIDDHEY LLC
Entity type:Organization
Organization Name:RIDDHEY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHINMAY
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAUHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:224-558-1092
Mailing Address - Street 1:215 E WARM SPRINGS RD STE 108
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-4248
Mailing Address - Country:US
Mailing Address - Phone:224-558-1092
Mailing Address - Fax:
Practice Address - Street 1:215 E WARM SPRINGS RD STE 108
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-4248
Practice Address - Country:US
Practice Address - Phone:224-558-1092
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-28
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV250027347Medicaid