Provider Demographics
NPI:1508049990
Name:LIFE IMPROVEMENT MEDICAL SUPPLY LLC
Entity Type:Organization
Organization Name:LIFE IMPROVEMENT MEDICAL SUPPLY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-285-8749
Mailing Address - Street 1:110 N BOULDER HWY
Mailing Address - Street 2:#120 157
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89015
Mailing Address - Country:US
Mailing Address - Phone:702-232-1817
Mailing Address - Fax:
Practice Address - Street 1:110 N BOULDER HWY
Practice Address - Street 2:#120
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89015
Practice Address - Country:US
Practice Address - Phone:702-232-1817
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-10
Last Update Date:2007-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV779070332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies