Provider Demographics
NPI:1730628389
Name:LAS VEGAS DME LLC
Entity type:Organization
Organization Name:LAS VEGAS DME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:KALDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-232-4610
Mailing Address - Street 1:8821 W SAHARA AVE
Mailing Address - Street 2:STE. 120
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-4815
Mailing Address - Country:US
Mailing Address - Phone:702-232-4610
Mailing Address - Fax:702-212-3300
Practice Address - Street 1:8821 W SAHARA AVE
Practice Address - Street 2:STE. 120
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-4815
Practice Address - Country:US
Practice Address - Phone:702-232-4610
Practice Address - Fax:702-212-3300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-15
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVE0060422017-5332B00000X, 332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies