Provider Demographics
NPI:1508630542
Name:MED-CARE PROVIDERS LLC
Entity Type:Organization
Organization Name:MED-CARE PROVIDERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:NORYDEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ESCANER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:725-577-9018
Mailing Address - Street 1:6330 W FLAMINGO RD UNIT 107
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89103-2234
Mailing Address - Country:US
Mailing Address - Phone:725-577-9018
Mailing Address - Fax:
Practice Address - Street 1:6330 W FLAMINGO RD UNIT 107
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89103-2234
Practice Address - Country:US
Practice Address - Phone:725-577-9018
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-09
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty