Organization
1ST MEDICAL SUPPLY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TATYANA V. WHITE (PRESIDENT)
(702) 870-0853
Entity
Organization
Contact information
Practice address
2725 S JONES BLVD, SUITE 106, LAS VEGAS, NV 89146-5605
(702) 870-0853
(702) 870-2797
Mailing address
2725 S JONES BLVD, SUITE 106, LAS VEGAS, NV 89146-5605
(702) 870-0853
(702) 870-2797
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
335E00000X
Prosthetic/Orthotic Supplier
S20592
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
S20592
FACILITY ACCREDITATION
NV
Enumeration date
04/25/2008
Last updated
10/18/2010
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