Provider Demographics
NPI:1487908265
Name:THE MEDICINE CABINET
Entity type:Organization
Organization Name:THE MEDICINE CABINET
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:MISS
Authorized Official - First Name:JANIS
Authorized Official - Middle Name:
Authorized Official - Last Name:BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-444-6082
Mailing Address - Street 1:3450 W CHEYENNE AVE
Mailing Address - Street 2:100
Mailing Address - City:N LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89032-8222
Mailing Address - Country:US
Mailing Address - Phone:702-444-6082
Mailing Address - Fax:702-650-2184
Practice Address - Street 1:3450 W CHEYENNE AVE
Practice Address - Street 2:100
Practice Address - City:N LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032-8222
Practice Address - Country:US
Practice Address - Phone:702-444-6082
Practice Address - Fax:702-650-2184
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-01
Last Update Date:2012-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV20051279874208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty