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Organization

THE MELFORD CLINIC LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
AL BERRY (CREDENTIALING MANAGER)
(000) 000-0000
Entity
Organization

Contact information

Practice address
2225 E FLAMINGO RD STE 100, LAS VEGAS, NV 89119-5126
(702) 748-5940
Mailing address
2225 E FLAMINGO RD STE 100, LAS VEGAS, NV 89119-5126
(702) 748-5940

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1982159638
NV
01
MS4040161
MEDICARE PROVIDER
NV
Enumeration date
10/14/2022
Last updated
06/07/2023
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