Eastern Family Medical And Dental Center | |
2212 S Eastern Ave Las Vegas NV 89104-4124 | |
(702) 735-9334 | |
(702) 735-9335 |
Full Name | Eastern Family Medical And Dental Center |
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Speciality | Clinic/Center |
Location | 2212 S Eastern Ave, Las Vegas, Nevada |
Authorized Official Name and Position | Walter B Davis (CEO) |
Authorized Official Contact | 7758886610 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Eastern Family Medical And Dental Center 3325 Research Way Carson City NV 89706-7913 Ph: (775) 888-6610 | Eastern Family Medical And Dental Center 2212 S Eastern Ave Las Vegas NV 89104-4124 Ph: (702) 735-9334 |
NPI Number | 1780831925 |
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Provider Enumeration Date | 08/19/2008 |
Last Update Date | 05/07/2015 |
Medicare PECOS PAC ID | 7113835307 |
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Medicare Enrollment ID | O20100626000516 |
Identifier | Type | State | Issuer |
---|---|---|---|
1780831925 | NPI | - | NPPES |
1780831925 | Medicaid | NV |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 291837 (Nevada) | Primary |
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