Provider Demographics
NPI:1730659749
Name:BEYOGLUTICAARET LLC
Entity Type:Organization
Organization Name:BEYOGLUTICAARET LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TALI
Authorized Official - Middle Name:
Authorized Official - Last Name:ARIK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:775-771-7570
Mailing Address - Street 1:330 S LOLA LN STE 200
Mailing Address - Street 2:
Mailing Address - City:PAHRUMP
Mailing Address - State:NV
Mailing Address - Zip Code:89048-0879
Mailing Address - Country:US
Mailing Address - Phone:775-771-7570
Mailing Address - Fax:
Practice Address - Street 1:330 S LOLA LN STE 200
Practice Address - Street 2:
Practice Address - City:PAHRUMP
Practice Address - State:NV
Practice Address - Zip Code:89048-0879
Practice Address - Country:US
Practice Address - Phone:775-771-7570
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-03
Last Update Date:2018-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1295755734Medicaid