Provider Demographics
NPI:1962608943
Name:CITY OF NORTH LAS VEGAS
Entity type:Organization
Organization Name:CITY OF NORTH LAS VEGAS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:MEGALLON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-633-1069
Mailing Address - Street 1:4040 LOSEE RD
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89030-3306
Mailing Address - Country:US
Mailing Address - Phone:702-633-1069
Mailing Address - Fax:702-399-8730
Practice Address - Street 1:4040 LOSEE RD
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89030
Practice Address - Country:US
Practice Address - Phone:702-633-1103
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CITY OF NORTH LAS VEGAS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-06-26
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
341600000X
NV3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV34209Medicare ID - Type Unspecified