Provider Demographics
NPI:1194019067
Name:NEM-CARE LLC
Entity Type:Organization
Organization Name:NEM-CARE LLC
Other - Org Name:NEM MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EDMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:PATVAKANYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-255-1114
Mailing Address - Street 1:4440 E WASHINGTON AVE STE 109
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89110-5793
Mailing Address - Country:US
Mailing Address - Phone:702-255-1114
Mailing Address - Fax:702-255-8199
Practice Address - Street 1:2670 N LAS VEGAS BLVD STE 109
Practice Address - Street 2:
Practice Address - City:N LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89030-5871
Practice Address - Country:US
Practice Address - Phone:702-399-0604
Practice Address - Fax:702-399-0607
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEM-CARE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-06-08
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty