# RUBY DOME ANESTHESIA LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215006028
- **Authorized official:** JAMES ROY COOPER CRNA (MEMBER)
- **Authorized official phone:** (775) 778-6634

## Contact information

- **Practice address:** 2001 ERRECART BLVD, NORTHEASTERN NEVADA REGIONAL HOSPITAL, ELKO, NV 89801
- **Practice address phone:** (775) 738-5151
- **Mailing address:** PO BOX 2723, ELKO, NV 89803
- **Mailing address phone:** (775) 778-6634
- **Mailing address fax:** (775) 778-6634

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | — | NV | Yes |

## Other

- **Enumeration date:** 11/07/2006
- **Last updated:** 08/22/2020