Organization
WEST COAST HEALTHCARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TRUMAN LORENZO THOMPSON (PRESIDENT)
(702) 789-8096
Entity
Organization
Contact information
Practice address
10217 MADISON GROVE AVENUE, LAS VEGAS, NV 89166-5266
(702) 789-8096
(702) 430-6698
Mailing address
10217 MADISON GROVE AVENUE, LAS VEGAS, NV 89166-5266
(702) 789-8096
(702) 380-8187
Taxonomy
Speciality
Code
Description
License number
State
261QR0208X
Mobile Radiology Clinic/Center
Primary
1008178853-001
NV
305S00000X
Point of Service
1008178853-001
NV
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
1008178853-001
NV
Other
Enumeration date
10/11/2011
Last updated
11/03/2016
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