Provider Demographics
NPI:1659008910
Name:PLATINUM MEDICAL SUPPLIES, LLC
Entity Type:Organization
Organization Name:PLATINUM MEDICAL SUPPLIES, LLC
Other - Org Name:PLATINUM MEDICAL LTC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SALLY
Authorized Official - Middle Name:L
Authorized Official - Last Name:CHIA
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:702-476-5597
Mailing Address - Street 1:6000 S EASTERN AVE # 1B
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-3125
Mailing Address - Country:US
Mailing Address - Phone:702-476-5597
Mailing Address - Fax:
Practice Address - Street 1:6000 S EASTERN AVE STE 1B
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-3125
Practice Address - Country:US
Practice Address - Phone:702-476-5597
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-05
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy