Organization
CHMM PAHRUMP MSO, LLC
Active
Parent organization
CHMM PAHRUMP MSO, LLC
Other names
Pahrump Community Physicians Group
Organization subpart
Yes
Provider details
NPI number
Legal business name
CHMM PAHRUMP MSO, LLC
Authorized official
TILLIE ANDRADE (MSO DIRECTOR)
(702) 449-9173
Entity
Organization
Contact information
Practice address
360 S LOLA LN, PAHRUMP, NV 89048-0884
(702) 449-9173
Mailing address
222 S MERAMEC AVE STE 202, SAINT LOUIS, MO 63105-3514
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
08/05/2022
Last updated
08/08/2022
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