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Organization
SPECIALTY ASC LLC
Active
Organization
SPECIALTY ASC LLC
Active
Other names
Surgical Arts Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MICHELLE BENNION (ADMINISTRATOR)
(702) 933-3600
Entity
Organization
Contact information
Practice address
9499 W CHARLESTON BLVD STE 250, LAS VEGAS, NV 89117-7148
(702) 933-3600
(702) 933-3601
Mailing address
9499 W CHARLESTON BLVD STE 250, LAS VEGAS, NV 89117-7148
(702) 933-3600
(702) 933-3601
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
3406ASC-8
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
29C0001049
MEDICARE DMERC
NV
05
—
4602060
—
NV
Enumeration date
09/04/2008
Last updated
10/10/2011
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