Provider Demographics
NPI:1194040899
Name:INTENSIVE CARE INC
Entity Type:Organization
Organization Name:INTENSIVE CARE INC
Other - Org Name:DIAGNOSTIC CENTER OF MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NELLI
Authorized Official - Middle Name:
Authorized Official - Last Name:TOVMASYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-534-7214
Mailing Address - Street 1:4012 S RAINBOW BLVD
Mailing Address - Street 2:STE K 320
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89103-2010
Mailing Address - Country:US
Mailing Address - Phone:702-534-5214
Mailing Address - Fax:
Practice Address - Street 1:3012 S DURANGO DR
Practice Address - Street 2:STE 1
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-9186
Practice Address - Country:US
Practice Address - Phone:702-534-5214
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-06
Last Update Date:2010-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV29D0537879291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory