Provider Demographics
NPI:1669165502
Name:B&J MEDICAL GROUP LLC
Entity type:Organization
Organization Name:B&J MEDICAL GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BILL
Authorized Official - Middle Name:
Authorized Official - Last Name:NASSAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-780-4441
Mailing Address - Street 1:8860 S MARYLAND PKWY STE 104
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-4005
Mailing Address - Country:US
Mailing Address - Phone:702-881-4033
Mailing Address - Fax:
Practice Address - Street 1:8860 S MARYLAND PKWY STE 104
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-4005
Practice Address - Country:US
Practice Address - Phone:702-881-4033
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:B&J MEDICAL GROUP LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-05-26
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based