Provider Demographics
NPI:1245921295
Name:ACCIDENT MEDICAL & INJURY CARE LLC
Entity type:Organization
Organization Name:ACCIDENT MEDICAL & INJURY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:JORGENSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-279-6977
Mailing Address - Street 1:9975 S EASTERN AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89183-7950
Mailing Address - Country:US
Mailing Address - Phone:702-600-7977
Mailing Address - Fax:
Practice Address - Street 1:3830 E FLAMINGO RD STE 201
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-6234
Practice Address - Country:US
Practice Address - Phone:702-659-5604
Practice Address - Fax:702-660-6186
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-18
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center