Organization
MAM MEDICAL SUPPLY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANA A. BEAVER (PRESIDENT)
(702) 369-0510
Entity
Organization
Contact information
Practice address
2300 E DESERT INN RD, STE 2, LAS VEGAS, NV 89109-3233
(702) 369-0510
(702) 369-9846
Mailing address
2300 E DESERT INN RD, STE 2, LAS VEGAS, NV 89109-3233
(702) 369-0510
(702) 369-9846
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
2000087.424
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MP00124
NV. ST. BOARD OF PHARMACY
NV
Enumeration date
06/21/2005
Last updated
08/22/2020
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