| Trucare Medical Inc | |
|
1721 E Charleston Blvd Las Vegas NV 89104-1902 | |
| (702) 685-0620 | |
| (702) 685-9674 |
| Full Name | Trucare Medical Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 1721 E Charleston Blvd, Las Vegas, Nevada |
| Authorized Official Name and Position | Bernard K Addo-quaye (PRESIDENT) |
| Authorized Official Contact | 7026576365 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Trucare Medical Inc 2290 Mcdaniel St Ste 2a N Las Vegas NV 89030-6330 Ph: (702) 657-6365 | Trucare Medical Inc 1721 E Charleston Blvd Las Vegas NV 89104-1902 Ph: (702) 685-0620 |
| NPI Number | 1629079884 |
|---|---|
| Provider Enumeration Date | 08/09/2005 |
| Last Update Date | 12/07/2022 |
| Medicare PECOS PAC ID | 0648257634 |
|---|---|
| Medicare Enrollment ID | O20040707001128 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629079884 | NPI | - | NPPES |
| 100505937 | Medicaid | NV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 9413 (Nevada) | Primary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| Provider Name | Bernard K Addo Quaye |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922009208 PECOS PAC ID: 2860470036 Enrollment ID: I20060206000797 |
| Provider Name | Mukwel E Aiyuk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275081481 PECOS PAC ID: 5193040871 Enrollment ID: I20170608001147 |
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