Organization
SEAO INTERALIA
Active
Organization
SEAO INTERALIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUDE NIBA (PRESIDENT)
(702) 831-0363
Entity
Organization
Contact information
Practice address
9082 VINTAGE WINE AVE, LAS VEGAS, NV 89148-4916
(702) 831-0363
Mailing address
9082 VINTAGE WINE AVE, LAS VEGAS, NV 89148-4916
(702) 831-0363
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
343900000X
NON EMERGENCY MEDICAL TRANSPORTATION
NV
Enumeration date
04/05/2019
Last updated
04/05/2019
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