| Innovative Medical Llc | |
|
4130 E Sunset Rd Henderson NV 89014-0212 | |
| (702) 670-0397 | |
| (702) 726-9531 |
| Full Name | Innovative Medical Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 4130 E Sunset Rd, Henderson, Nevada |
| Authorized Official Name and Position | Kevin Ramsey (OWNER) |
| Authorized Official Contact | 7028846292 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Innovative Medical Llc 209 S Stephanie St # B146 Henderson NV 89012-5501 Ph: (702) 884-6292 | Innovative Medical Llc 4130 E Sunset Rd Henderson NV 89014-0212 Ph: (702) 670-0397 |
| NPI Number | 1396383105 |
|---|---|
| Provider Enumeration Date | 12/12/2019 |
| Last Update Date | 12/12/2019 |
| Medicare PECOS PAC ID | 3072948876 |
|---|---|
| Medicare Enrollment ID | O20200124002589 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396383105 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Kevin P Ramsey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053591149 PECOS PAC ID: 5395882716 Enrollment ID: I20110701000106 |
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