Provider Demographics
NPI:1336689330
Name:MEDICAL CONCEPTS LLC
Entity Type:Organization
Organization Name:MEDICAL CONCEPTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGN PART
Authorized Official - Prefix:
Authorized Official - First Name:RICKI
Authorized Official - Middle Name:
Authorized Official - Last Name:DIBERNARDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-246-8246
Mailing Address - Street 1:7260 W AZURE DR
Mailing Address - Street 2:#140 STE 2136
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89130-7999
Mailing Address - Country:US
Mailing Address - Phone:561-246-8246
Mailing Address - Fax:
Practice Address - Street 1:7260 W AZURE DR
Practice Address - Street 2:#140 STE 2136
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89130-7999
Practice Address - Country:US
Practice Address - Phone:561-246-8246
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-24
Last Update Date:2017-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty