1619862364 NPI number — RX MUSCLE WORK LTD

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619862364 NPI number — RX MUSCLE WORK LTD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RX MUSCLE WORK LTD
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1619862364
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/23/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2481 W HORIZON RIDGE PKWY STE 100
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HENDERSON
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89052-5926
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
775-515-7770
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2481 W HORIZON RIDGE PKWY STE 100
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HENDERSON
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89052-5926
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
775-515-7770
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/12/2025

Additional Information

Authorized Official

Authorized Official Last Name:
ZAHIROVIC
Authorized Official First Name:
KEDRIAN
Authorized Official Middle Name:
GERMAINE
Authorized Official Title or Position:
GENERAL MANAGER
Authorized Official Telephone Number:
702-530-2215

Provider Taxonomy Codes

  • Taxonomy code: 225700000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 100158 . This is a "HUMANA GOLD PLUS HMO" identifier , issued by the state of ( NV ) . This identifiers is of the category "OTHER".
  • Identifier: 100268 . This is a "TRICARE (NATIONWIDE)" identifier , issued by the state of ( NV ) . This identifiers is of the category "OTHER".
  • Identifier: 101353 . This is a "PROMINENCE HEALTH PLAN OF NEVADA- MEDICARE ADVANTAGE" identifier , issued by the state of ( NV ) . This identifiers is of the category "OTHER".
  • Identifier: 101382 . This is a "HEALTH PLAN OF NEVADA (SIERRA HEALTH SERVICES ENCOUNTERS)" identifier , issued by the state of ( NV ) . This identifiers is of the category "OTHER".
  • Identifier: 84594 . This is a "AMERICAN SPECIALTY HEALTH/ HEALTHFIRST" identifier , issued by the state of ( NV ) . This identifiers is of the category "OTHER".
  • Identifier: 101382 . This is a "SIERRA HEALTH AND LIFE (HEALTH PLAN OF NEVADA)" identifier , issued by the state of ( NV ) . This identifiers is of the category "OTHER".
  • Identifier: 100268 . This is a "TRICARE WEST" identifier , issued by the state of ( NV ) . This identifiers is of the category "OTHER".
  • Identifier: 10082 . This is a "CIGNA HEALTH PLAN PPO" identifier , issued by the state of ( NV ) . This identifiers is of the category "OTHER".
  • Identifier: 100003 . This is a "AETNA LIFE & CASUALTY COMPANY" identifier , issued by the state of ( NV ) . This identifiers is of the category "OTHER".
  • Identifier: 100003 . This is a "AETNA MEDICARE PPO" identifier , issued by the state of ( NV ) . This identifiers is of the category "OTHER".
  • Identifier: 10082 . This is a "CIGNA" identifier , issued by the state of ( NV ) . This identifiers is of the category "OTHER".
  • Identifier: 953402799 . This is a "AETNA" identifier , issued by the state of ( NV ) . This identifiers is of the category "OTHER".
  • Identifier: 100273 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( NV ) . This identifiers is of the category "OTHER".
  • Identifier: 100003 . This is a "AETNA MEDICARE HMO" identifier , issued by the state of ( NV ) . This identifiers is of the category "OTHER".
  • Identifier: ASH01 . This is a "AMERICAN SPECIALTY HEALTH" identifier , issued by the state of ( NV ) . This identifiers is of the category "OTHER".
  • Identifier: 100044 . This is a "BLUE CROSS BLUE SHIELD NEVADA (ANTHEM BCBS NV)" identifier , issued by the state of ( NV ) . This identifiers is of the category "OTHER".
  • Identifier: 100158 . This is a "HUMANA MEDICAID HMO" identifier , issued by the state of ( NV ) . This identifiers is of the category "OTHER".
  • Identifier: 100273 . This is a "UNITED HEALTHCARE (UHC) MEDICAID PLANS" identifier , issued by the state of ( NV ) . This identifiers is of the category "OTHER".
  • Identifier: 100273 . This is a "UNITED HEALTHCARE DUAL COMPLETE" identifier , issued by the state of ( NV ) . This identifiers is of the category "OTHER".




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