Provider Demographics
NPI:1750824371
Name:LASHER SPORT
Entity Type:Organization
Organization Name:LASHER SPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:LASHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-229-5274
Mailing Address - Street 1:5720 ARVILLE ST
Mailing Address - Street 2:STE 105
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89118-3036
Mailing Address - Country:US
Mailing Address - Phone:907-529-8833
Mailing Address - Fax:
Practice Address - Street 1:5720 ARVILLE ST
Practice Address - Street 2:STE 105
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89118-3036
Practice Address - Country:US
Practice Address - Phone:907-529-8833
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-30
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2000248-031-170332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies