Organization
AMIRA MEDICAL SUPPLY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL O IGELEKE (TREASURER/ADMINISTRATOR)
(702) 547-5991
Entity
Organization
Contact information
Practice address
3650 E FLAMINGO RD, SUITE 4, LAS VEGAS, NV 89121-4934
(702) 547-5991
(702) 547-5992
Mailing address
3650 E FLAMINGO RD, SUITE 4, LAS VEGAS, NV 89121-4934
(702) 547-5991
(702) 547-5992
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
NV20111500986
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6684680001
PROVIDER TRANSACTION ACCESS NUMBER
NV
Enumeration date
08/30/2011
Last updated
07/02/2012
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