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Organization

JGBB LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TERESA PATAWARAN BUCO RN (ADMINISTRATOR)
(702) 790-4404
Entity
Organization

Contact information

Practice address
801 S RANCHO DR STE D1-B, LAS VEGAS, NV 89106-3854
(702) 478-5133
(702) 478-5401
Mailing address
801 S RANCHO DR STE D1-B, LAS VEGAS, NV 89106-3854
(702) 825-4900
(702) 977-8150

Taxonomy

Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
163WH0200X
Home Health Registered Nurse
163WI0500X
Infusion Therapy Registered Nurse
163WP2201X
Ambulatory Care Registered Nurse
164W00000X
Licensed Practical Nurse
261Q00000X
Clinic/Center
261QH0100X
Health Service Clinic/Center
261QI0500X
Infusion Therapy Clinic/Center
Primary
261QP2400X
Prison Health Clinic/Center
332BN1400X
Nursing Facility Supplies (DME)

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
250004956
NV
Enumeration date
10/05/2018
Last updated
01/13/2026
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