Provider Demographics
NPI:1033278445
Name:JOY MOBILITY & MEDICAL SUPPLIES
Entity Type:Organization
Organization Name:JOY MOBILITY & MEDICAL SUPPLIES
Other - Org Name:ENRIQUETA TRINIDAD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ISADORA
Authorized Official - Middle Name:DEGUZMAN
Authorized Official - Last Name:TAGUD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-434-2458
Mailing Address - Street 1:3280 E. TROPICANA AVENUE
Mailing Address - Street 2:SUITE D
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121-7344
Mailing Address - Country:US
Mailing Address - Phone:702-434-2458
Mailing Address - Fax:702-434-7072
Practice Address - Street 1:3280 E. TROPICANA AVENUE
Practice Address - Street 2:SUITE D
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-7344
Practice Address - Country:US
Practice Address - Phone:702-434-2458
Practice Address - Fax:702-434-7072
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2008-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2000126424332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV5862600001Medicare NSC