Provider Demographics
NPI:1780001347
Name:CARELINK MEDICAL GROUP OF NEVADA LLC
Entity Type:Organization
Organization Name:CARELINK MEDICAL GROUP OF NEVADA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMNISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LILIBETH
Authorized Official - Middle Name:A
Authorized Official - Last Name:MACACHOR
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:702-586-0175
Mailing Address - Street 1:320 E WARM SPRINGS RD
Mailing Address - Street 2:SUITE 4A UNIT 7
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-4243
Mailing Address - Country:US
Mailing Address - Phone:702-586-0175
Mailing Address - Fax:702-586-2227
Practice Address - Street 1:320 E WARM SPRINGS RD
Practice Address - Street 2:SUITE 4A UNIT 7
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-4243
Practice Address - Country:US
Practice Address - Phone:702-586-0175
Practice Address - Fax:702-586-2227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-20
Last Update Date:2014-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center