# CHMM PAHRUMP MSO, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** CHMM PAHRUMP MSO, LLC
- **Other names:** Pahrump Community Physicians Group
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1417684713
- **Legal business name:** CHMM PAHRUMP MSO, LLC
- **Authorized official:** TILLIE ANDRADE (MSO DIRECTOR)
- **Authorized official phone:** (702) 449-9173

## Contact information

- **Practice address:** 360 S LOLA LN, PAHRUMP, NV 89048-0884
- **Practice address phone:** (702) 449-9173
- **Mailing address:** 222 S MERAMEC AVE STE 202, SAINT LOUIS, MO 63105-3514

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/05/2022
- **Last updated:** 08/08/2022