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Organization
SNNAC LLC
Active
Organization
SNNAC LLC
Active
Other names
Azura Surgery Center Northern Nevada
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES SULLIVAN III DO (AUTHORIZED OFFICIAL)
(775) 232-5387
Entity
Organization
Contact information
Practice address
932 RYLAND ST, RENO, NV 89502-1605
(775) 853-4166
Mailing address
40 VALLEY STREAM PKWY STE 100, MALVERN, PA 19355-1407
(610) 644-8900
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
250001294
—
NV
Enumeration date
11/17/2017
Last updated
04/27/2020
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