1629166624 NPI number — AMBULATORY SURGICAL CENTER OF SOUTHERN NEVADA LLC

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 1629166624 NPI number — AMBULATORY SURGICAL CENTER OF SOUTHERN NEVADA LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AMBULATORY SURGICAL CENTER OF SOUTHERN NEVADA 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:
Provider Other Organization Name Type Code:
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:
1629166624
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/09/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 50785
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:
89016-0785
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
702-952-1660
Provider Business Mailing Address Fax Number:
702-952-1665

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6950 S CIMARRON ROAD
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
LAS VEGAS
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89113
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-952-1660
Provider Business Practice Location Address Fax Number:
702-952-1665
Provider Enumeration Date:
10/11/2006

Additional Information

Authorized Official

Authorized Official Last Name:
NEMEC
Authorized Official First Name:
FRANK
Authorized Official Middle Name:
J
Authorized Official Title or Position:
MEDICAL DIRECTOR
Authorized Official Telephone Number:
702-952-1660

Provider Taxonomy Codes

  • Taxonomy code: 261QA1903X , with the licence number:  5334ASC-0 , registered in the state of NV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com