Organization
KSM CORPORATE HOLDINGS LLC
Active
Other names
Nevada Mobility
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEVIN MICHAEL MCMANUS (ONWER)
(702) 497-7112
Entity
Organization
Contact information
Practice address
9430 W LAKE MEAD BLVD, SUITE 3, LAS VEGAS, NV 89134-8338
(709) 998-2118
Mailing address
9430 W LAKE MEAD BLVD, SUITE 3, LAS VEGAS, NV 89134-8338
(709) 998-2118
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
1016002025-001
NV
332BC3200X
Customized Equipment (DME)
1016002025-001
NV
Other
Enumeration date
10/04/2013
Last updated
04/12/2017
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