Provider Demographics
NPI:1851569537
Name:MEDICAL SUPPLY OF NEVADA, INC.
Entity Type:Organization
Organization Name:MEDICAL SUPPLY OF NEVADA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:SEGAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-558-9305
Mailing Address - Street 1:115 S WATER ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89015-7221
Mailing Address - Country:US
Mailing Address - Phone:702-558-9305
Mailing Address - Fax:702-558-9489
Practice Address - Street 1:115 S WATER ST
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89015-7221
Practice Address - Country:US
Practice Address - Phone:702-558-9305
Practice Address - Fax:702-558-9489
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-14
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVMP00438332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies