Provider Demographics
NPI:1558091512
Name:COMPLETE MEDICAL EQUIPMENT AND SUPPLY LLC
Entity Type:Organization
Organization Name:COMPLETE MEDICAL EQUIPMENT AND SUPPLY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MATT
Authorized Official - Middle Name:
Authorized Official - Last Name:MCWILLIAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-478-7132
Mailing Address - Street 1:200 HOOVER AVE UNIT 903
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89101-6875
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:200 HOOVER AVE UNIT 903
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89101-6875
Practice Address - Country:US
Practice Address - Phone:800-478-7132
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-13
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies