Organization
NEVADA MEDICAL SYSTEMS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRANT MASSMAN (OWNER)
(702) 399-1600
Entity
Organization
Contact information
Practice address
2516 E LAKE MEAD BLVD, NORTH LAS VEGAS, NV 89030-6414
(702) 399-1600
(702) 399-5375
Mailing address
PO BOX 897, BOISE, ID 83701
(702) 399-1600
(702) 399-5375
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
1938NTC-10
NV
261QM2800X
Methadone Clinic
Primary
—
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100502427
—
NV
Enumeration date
10/23/2006
Last updated
06/06/2011
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