WILDCREEK SURGERY CENTER NPI 1003875873

NPI Information

NPI: 1003875873
Provider Name: WILDCREEK SURGERY CENTER
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

CLIA Number: 29D0936425

Address:
2285 GREEN VISTA DR
SPARKS, NV
ZIP 89431
Phone: (775) 674-1110
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WILDCREEK SURGERY CENTER is an ambulatory surgical clinic center in Sparks, NV. WILDCREEK SURGERY CENTER NPI is 1003875873. The provider is registered as an organization entity type.

The provider's business location address is:

2285 GREEN VISTA DR
SPARKS, NV
ZIP 89431-532
Phone: (775) 674-1110
Fax: (775) 674-1114

The provider's authorized official is Douglas K. Devries .
The authorized official title is Owner and has the following contact phone number (775) 674-1110.

The CLIA number assigned to this NPI record is 29D0936425 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/21/2006 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. 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	1830ASC-8	NEVADA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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