ALTA-ROSE SURGERY CENTER LLC NPI 1841259611

NPI Information

NPI: 1841259611
Provider Name: ALTA-ROSE SURGERY CENTER LLC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

CLIA Number: 29D1029994

Address:
501 ROSE ST
SUITE 110
LAS VEGAS, NV
ZIP 89106
Phone: (702) 386-9906
Get Directions

ALTA-ROSE SURGERY CENTER LLC is an ambulatory surgical clinic center in Las Vegas, NV. ALTA-ROSE SURGERY CENTER LLC NPI is 1841259611. The provider is registered as an organization entity type.

The provider's business location address is:

501 ROSE ST
SUITE 110
LAS VEGAS, NV
ZIP 89106-053
Phone: (702) 386-9906
Fax: (702) 386-9910

The provider's authorized official is Douglas K Devries .
The authorized official title is Owner and has the following contact phone number (775) 674-1100.

The CLIA number assigned to this NPI record is 29D1029994 - 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 11/28/2023.

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	3981ASC-3	NEVADA	Yes

Other Identifiers

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

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	100505697	MEDICAID	NEVADA

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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