BOULDER CITY OUTPATIENT SURGERY CENTER - NPI NUMBER 1467782961

Summary

Provider Name: BOULDER CITY OUTPATIENT SURGERY CENTER

NPI Number: 1467782961

Clasification: Clinic/Center (261QA1903X)

Specialization: Ambulatory Surgical

Address:
901 ADAMS BLVD
BOULDER CITY, NV
ZIP 89005

Phone Number: (702) 369-6784



Detailed Information

BOULDER CITY OUTPATIENT SURGERY CENTER is an ambulatory surgical clinic/center in Boulder City, NV. The assigned NPI number for this provider is 1467782961 and is registered as an organization entity type.

The provider's business address is:

901 ADAMS BLVD
BOULDER CITY, NV
ZIP 89005-213
Phone: (702) 369-6784
Fax: (702) 543-5313

The provider's authorized official is Robert W Barnes .
The authorized official title is Administrator and has the following contact phone number (702) 369-6784.

The enumeration date for this NPI number is 1/5/2010 and was last updated on 1/5/2010.

Map - Location of Practice

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Taxonomy Codes

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
1 261QA1903X Clinic/Center Ambulatory Surgical Yes

NPI Record

No. Field Name Field Value
1 NPI 1467782961
2 Entity Type Code 2
3 Employer Identification Number EIN
4 Provider Organization Name Legal Business Name BOULDER CITY OUTPATIENT SURGERY CENTER
5 Provider First Line Business Practice Location Address 901 ADAMS BLVD
6 Provider Business Practice Location Address City Name BOULDER CITY
7 Provider Business Practice Location Address State Name NV
8 Provider Business Practice Location Address Postal Code 890052213
9 Provider Business Practice Location Address Country Code If outside U S US
10 Provider Business Practice Location Address Telephone Number 7023696784
11 Provider Business Practice Location Address Fax Number 7025435313
12 Provider Enumeration Date 1/5/2010
13 Last Update Date 1/5/2010
14 Authorized Official Last Name BARNES
15 Authorized Official First Name ROBERT
16 Authorized Official Middle Name W
17 Authorized Official Title or Position ADMINISTRATOR
18 Authorized Official Telephone Number 7023696784
19 Healthcare Provider Taxonomy Code 1 261QA1903X
20 Healthcare Provider Primary Taxonomy Switch 1 Y
21 Is Organization Subpart N
22 Authorized Official Name Prefix Text MR.

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This page was last updated on: 11/14/2014
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.