Provider Demographics
NPI:1366700015
Name:STATE MEDICAL EQUIPMENT LIMITED LIABILITY COMPANY
Entity type:Organization
Organization Name:STATE MEDICAL EQUIPMENT LIMITED LIABILITY COMPANY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:MAY
Authorized Official - Middle Name:FLORES
Authorized Official - Last Name:CUENCA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-538-9555
Mailing Address - Street 1:3950 E SUNSET RD
Mailing Address - Street 2:SUITE 112
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89120-4905
Mailing Address - Country:US
Mailing Address - Phone:702-538-9555
Mailing Address - Fax:702-538-8433
Practice Address - Street 1:3950 E SUNSET RD
Practice Address - Street 2:SUITE 112
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-4905
Practice Address - Country:US
Practice Address - Phone:702-538-9555
Practice Address - Fax:702-538-8433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-01
Last Update Date:2019-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies