LAS VEGAS KIDNEY CLINIC INC. NPI 1245234145

NPI Information

LAS VEGAS KIDNEY CLINIC INC. is a medical specialty clinic center in North Las Vegas, NV. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). LAS VEGAS KIDNEY CLINIC INC. NPI is 1245234145. The provider is registered as an organization entity type.

The provider's business location address is:

1905 CIVIC CENTER DR
STE 201
NORTH LAS VEGAS, NV
ZIP 89030-116
Phone: (702) 214-9516
Fax: (702) 214-9415

The provider's authorized official is Galen Robert Bennett .
The authorized official title is Administrator and has the following contact phone number (702) 214-9516.

The CLIA number assigned to this NPI record is 29D2194109 - other - clinical research center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/8/2005 and was last updated on 6/6/2008.

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:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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