1205184801 NPI number — BIO-MEDICAL APPLICATIONS OF NEVADA, INC.

Table of content: MRS. NICOLE LEANNE FISHER M.S. SLP (NPI 1053693853)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205184801 NPI number — BIO-MEDICAL APPLICATIONS OF NEVADA, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BIO-MEDICAL APPLICATIONS OF NEVADA, INC.
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:
1205184801
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/20/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1905 CIVIC CENTER DR
Provider Second Line Business Mailing Address:
SUITE 201
Provider Business Mailing Address City Name:
NORTH LAS VEGAS
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89030-7143
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
702-214-9516
Provider Business Mailing Address Fax Number:
702-214-9415

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1905 CIVIC CENTER DR
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
NORTH LAS VEGAS
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89030-7143
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-214-9516
Provider Business Practice Location Address Fax Number:
702-214-9415
Provider Enumeration Date:
08/29/2012

Additional Information

Authorized Official

Authorized Official Last Name:
FAWCETT
Authorized Official First Name:
MARK
Authorized Official Middle Name:
R
Authorized Official Title or Position:
VP AND TREASURER
Authorized Official Telephone Number:
781-699-9000

Provider Taxonomy Codes

  • Taxonomy code: 261QE0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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