Organization
CITY OF MESQUITE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARSHA V BLACK C.P.C. (MANAGER REP.)
(801) 295-9811
Entity
Organization
Contact information
Practice address
10 E MESQUITE BLVD., MESQUITE, NV 89027-4706
(702) 346-2690
(702) 346-5242
Mailing address
DEPT. 8815, LOS ANGELES, CA 90084-8815
(213) 614-3049
(866) 575-5490
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
#314
NV
341600000X
Ambulance
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003202331
—
NV
01
—
590014513
R.R.
—
01
—
NV1263
N.B. B.C/B.S.
NV
05
—
XMTE06486
—
CA
Enumeration date
01/02/2007
Last updated
02/23/2010
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