Provider Demographics
NPI:1154643948
Name:MIRAMAR NEVADA LLC
Entity Type:Organization
Organization Name:MIRAMAR NEVADA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:HOWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-400-4500
Mailing Address - Street 1:118 CORPORATE PARK DR
Mailing Address - Street 2:STE 123
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-8771
Mailing Address - Country:US
Mailing Address - Phone:702-478-5353
Mailing Address - Fax:702-478-5959
Practice Address - Street 1:118 CORPORATE PARK DR
Practice Address - Street 2:STE 123
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-8771
Practice Address - Country:US
Practice Address - Phone:702-478-5353
Practice Address - Fax:702-478-5959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-19
Last Update Date:2010-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment