| Pmd Ventures Llc | |
|
1840 E Calvada Blvd Pahrump NV 89048-5866 | |
| (702) 904-0260 | |
| Not Available |
| Full Name | Pmd Ventures Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1840 E Calvada Blvd, Pahrump, Nevada |
| Authorized Official Name and Position | David Hardy (OWNER) |
| Authorized Official Contact | 7029040260 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pmd Ventures Llc 9867 Antelope Canyon Ave Las Vegas NV 89147-7739 Ph: () - | Pmd Ventures Llc 1840 E Calvada Blvd Pahrump NV 89048-5866 Ph: (702) 904-0260 |
| NPI Number | 1861031601 |
|---|---|
| Provider Enumeration Date | 12/26/2019 |
| Last Update Date | 12/26/2019 |
| Certification Date | 12/26/2019 |
| Medicare PECOS PAC ID | 4082035811 |
|---|---|
| Medicare Enrollment ID | O20200604000010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861031601 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Priscilla Vernice Adjorlolo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780887463 PECOS PAC ID: 1759568470 Enrollment ID: I20190927001338 |
| Provider Name | Hisbay H Ali |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1306127311 PECOS PAC ID: 0446524565 Enrollment ID: I20210716002733 |
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