Provider Demographics
NPI:1568152023
Name:LORDLITA R WIRTZ AND ASSOCIATES LLC
Entity Type:Organization
Organization Name:LORDLITA R WIRTZ AND ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:LORDLITA
Authorized Official - Middle Name:RUSIANA
Authorized Official - Last Name:WIRTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-913-6570
Mailing Address - Street 1:4780 W ANN RD # 5-338
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89031-3470
Mailing Address - Country:US
Mailing Address - Phone:702-806-7452
Mailing Address - Fax:
Practice Address - Street 1:98 CORPORATE PARK DR
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-8701
Practice Address - Country:US
Practice Address - Phone:702-806-7452
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LORDLITA R WIRTZ AND ASSOCIATES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-05-09
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251F00000XAgenciesHome Infusion