1861645780 NPI number — CHW NEVADA IMAGING COMPANY LLC

Table of content: (NPI 1861645780)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861645780 NPI number — CHW NEVADA IMAGING COMPANY LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHW NEVADA IMAGING COMPANY LLC
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:
NEVADA IMAGING CENTERS--SIENA
Provider Other Organization Name Type Code:
3
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:
1861645780
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/28/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2835 S JONES BLVD
Provider Second Line Business Mailing Address:
SUITE 3
Provider Business Mailing Address City Name:
LAS VEGAS
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89146-5354
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
702-597-1145
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
861 CORONADO CENTER DR
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
HENDERSON
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89052-3992
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-968-9729
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/23/2008

Additional Information

Authorized Official

Authorized Official Last Name:
DAVIS
Authorized Official First Name:
ROD
Authorized Official Middle Name:
A.
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
702-616-5500

Provider Taxonomy Codes

  • Taxonomy code: 261QR0206X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: P00731251 . This is a "RAILROAD" identifier , issued by the state of ( NV ) . This identifiers is of the category "OTHER".




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