# ALTA-ROSE SURGERY CENTER LLC

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

## Provider details

- **NPI number:** 1841259611
- **Authorized official:** DOUGLAS K DEVRIES MD (OWNER)
- **Authorized official phone:** (775) 674-1100

## Contact information

- **Practice address:** 501 ROSE ST, SUITE 110, LAS VEGAS, NV 89106-4053
- **Practice address phone:** (702) 386-9906
- **Practice address fax:** (702) 386-9910
- **Mailing address:** 501 ROSE ST, SUITE 110, LAS VEGAS, NV 89106-4053
- **Mailing address phone:** (702) 386-9906
- **Mailing address fax:** (702) 386-9910

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 3981ASC-3 | NV | Yes |

## Other

- **Enumeration date:** 03/21/2006
- **Last updated:** 11/28/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100505697 | — | NV |