Provider Demographics
NPI:1932523974
Name:KSM CORPORATE HOLDINGS
Entity Type:Organization
Organization Name:KSM CORPORATE HOLDINGS
Other - Org Name:NEVADA MOBILITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:M
Authorized Official - Last Name:MCMANUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-998-2118
Mailing Address - Street 1:9430 W LAKE MEAD BLVD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89134-8338
Mailing Address - Country:US
Mailing Address - Phone:702-998-2118
Mailing Address - Fax:
Practice Address - Street 1:9430 W LAKE MEAD BLVD
Practice Address - Street 2:SUITE 3
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89134-8338
Practice Address - Country:US
Practice Address - Phone:702-998-2118
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-11
Last Update Date:2014-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV20121603160332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment