Provider Demographics
NPI:1700123759
Name:PA4FREE LLC
Entity Type:Organization
Organization Name:PA4FREE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:BARTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:855-722-7747
Mailing Address - Street 1:10170 W TROPICANA AVE # 156-290
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89147-8465
Mailing Address - Country:US
Mailing Address - Phone:855-722-7747
Mailing Address - Fax:855-458-2910
Practice Address - Street 1:10170 W TROPICANA AVE # 156-290
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89147-8465
Practice Address - Country:US
Practice Address - Phone:855-722-7747
Practice Address - Fax:855-458-2910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-10
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Single Specialty