1588139026 NPI number — ROSEMAN UNIVERSITY OF HEALTH SCIENCES, A NEVADA NON-PROFIT CORP

Table of content: (NPI 1588139026)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588139026 NPI number — ROSEMAN UNIVERSITY OF HEALTH SCIENCES, A NEVADA NON-PROFIT CORP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ROSEMAN UNIVERSITY OF HEALTH SCIENCES, A NEVADA NON-PROFIT CORP
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:
1588139026
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/18/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
02/12/2021
NPI Reactivation Date:
05/18/2021

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11 SUNSET WAY
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:
89014-2333
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
702-990-4433
Provider Business Mailing Address Fax Number:
702-968-5577

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4 SUNSET WAY STE B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HENDERSON
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89014-2015
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-990-4433
Provider Business Practice Location Address Fax Number:
702-968-5577
Provider Enumeration Date:
10/11/2018

Additional Information

Authorized Official

Authorized Official Last Name:
LICARI
Authorized Official First Name:
FRANK
Authorized Official Middle Name:
Authorized Official Title or Position:
DEAN
Authorized Official Telephone Number:
801-878-1400

Provider Taxonomy Codes

  • Taxonomy code: 122300000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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