Meditech Laboratories Inc

Primary specialty

Compounding PharmacyTaxonomy code 3336C0004X

License

PH01794 Issued in NV

Legal business name

MEDITECH LABORATORIES INC

Practice address

3200 Polaris Ave Ste 27
Las Vegas, NV 89102-8379

Phone

(702) 220-6073

NPI assigned

Mar 14, 2013

Last updated

May 31, 2016By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kim Tran

Title

Owner

Phone

(702) 220-6073

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• David Shimp

  • Pharmacist
  • Las Vegas, NV
  • NPI 1760759401
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1363219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464652800000",
    "number": "1073854162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 POLARIS AVE STE 27",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891028379",
            "telephone_number": "702-220-6073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 POLARIS AVE STE 27",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891028379",
            "telephone_number": "702-220-6073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDITECH LABORATORIES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-14",
        "last_updated": "2016-05-31",
        "status": "A",
        "authorized_official_last_name": "TRAN",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-220-6073"
    },
    "taxonomies": [
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NV",
            "license": "PH01794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jorge Luis Medinilla Jimenez
• Dalila Medinilla
• Yadira Medinilla
• Medinix Medical Services Singh PLLC (Astrana Care of Nevada)
• Medisoft LLC
• Medlab LLC (MedLab)
• Medlegal Teams Khavkin MD PLLC (Medlegal Teams)
• Kenesha Michelle Medley, NP
• Talya Medley
• Medlife Transportation LLC (Medlife Transportation)

• Compounding Pharmacy in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Compounding Pharmacy in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.