Provider Demographics
NPI:1639227895
Name:UNITED MEDICAL SUPPLIES CORP
Entity Type:Organization
Organization Name:UNITED MEDICAL SUPPLIES CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ANIL
Authorized Official - Middle Name:K
Authorized Official - Last Name:MATHUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-368-3003
Mailing Address - Street 1:3111 S VALLEY VIEW BLVD
Mailing Address - Street 2:B107
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-8317
Mailing Address - Country:US
Mailing Address - Phone:702-368-3003
Mailing Address - Fax:702-368-3007
Practice Address - Street 1:3111 S VALLEY VIEW BLVD
Practice Address - Street 2:B107
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-8317
Practice Address - Country:US
Practice Address - Phone:702-368-3003
Practice Address - Fax:702-368-3007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVMP00149332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV4490160001Medicare ID - Type UnspecifiedPROVIDER NUMBER