| Golden Victory Medical | |
|
2870 S Maryland Pkwy Ste 200 Las Vegas NV 89109-1580 | |
| (702) 703-1950 | |
| Not Available |
| Full Name | Golden Victory Medical |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 2870 S Maryland Pkwy Ste 200, Las Vegas, Nevada |
| Authorized Official Name and Position | Elizabeth Brown (APRN/OWNER) |
| Authorized Official Contact | 9529237256 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Golden Victory Medical 2505 Anthem Village Dr Ste E-101 Henderson NV 89052-5505 Ph: (952) 923-7256 | Golden Victory Medical 2870 S Maryland Pkwy Ste 200 Las Vegas NV 89109-1580 Ph: (702) 703-1950 |
| NPI Number | 1609360254 |
|---|---|
| Provider Enumeration Date | 06/18/2018 |
| Last Update Date | 04/28/2022 |
| Certification Date | 04/28/2022 |
| Medicare PECOS PAC ID | 1951651272 |
|---|---|
| Medicare Enrollment ID | O20210727000533 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609360254 | NPI | - | NPPES |
| Provider Name | Ashley E Barr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184164766 PECOS PAC ID: 2961776935 Enrollment ID: I20180215002310 |
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