1750417622 NPI number — LAS VEGAS HEALTH SERVICES INC

Table of content: (NPI 1750417622)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750417622 NPI number — LAS VEGAS HEALTH SERVICES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LAS VEGAS HEALTH SERVICES INC
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:
1750417622
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/17/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2600 S RAINBOW BLVD
Provider Second Line Business Mailing Address:
SUITE 108
Provider Business Mailing Address City Name:
LAS VEGAS
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89146-4006
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
702-921-6829
Provider Business Mailing Address Fax Number:
702-921-6828

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2600 S RAINBOW BLVD
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
LAS VEGAS
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89146-4006
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-921-6829
Provider Business Practice Location Address Fax Number:
702-921-6828
Provider Enumeration Date:
02/26/2007

Additional Information

Authorized Official

Authorized Official Last Name:
HAMID
Authorized Official First Name:
ZAHID
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
702-921-6829

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  11643 , 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)

  • Identifier: 100508138 , issued by the state of ( NV ) . This identifiers is of the category "MEDICAID".




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