Provider Demographics
NPI:1184152274
Name:UNLV MEDICINE
Entity type:Organization
Organization Name:UNLV MEDICINE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOANN
Authorized Official - Middle Name:
Authorized Official - Last Name:STROBBE
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:702-272-1352
Mailing Address - Street 1:3016 W CHARLESTON BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-1973
Mailing Address - Country:US
Mailing Address - Phone:702-968-4038
Mailing Address - Fax:702-968-4033
Practice Address - Street 1:4000 E CHARLESTON BLVD STE B130
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89104-6681
Practice Address - Country:US
Practice Address - Phone:702-968-4038
Practice Address - Fax:702-968-4033
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNLV MEDICINE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-06-01
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy