EMERALD LAKE INC NPI 1295956233

NPI Information

  • NPI: 1295956233
  • Provider Name: EMERALD LAKE, INC
  • Classification: Durable Medical Equipment & Medical Supplies - 332B00000X
  • Entity Type: Organization
  • Doing Business As: EMERALD MEDICAL SUPPLY
  • Address: 500 S MARTIN L KING BLVD STE D
    LAS VEGAS, NV
    ZIP 89106
  • Phone: (702) 678-6776

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NPI Details

EMERALD LAKE, INC is a durable medical equipment medical supplies in Las Vegas, NV. The provider is a supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time. EMERALD LAKE, INC NPI is 1295956233. The provider is registered as an organization entity type.
The provider Is Doing Business As Emerald Medical Supply.

The provider's business location address is:

500 S MARTIN L KING BLVD STE D
LAS VEGAS, NV
ZIP 89106-424
Phone: (702) 678-6776
Fax: (702) 678-6661

The provider's authorized official is Marcel Ezeoke .
The authorized official title is Manager and has the following contact phone number (702) 678-6776.

The enumeration date for this NPI number is 5/1/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1332B00000XDurable Medical Equipment & Medical SuppliesNEVADAYes

What is NPI?

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This page was last updated on: 11/21/2025

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