# SOUTH MEADOWS ENDOSCOPY CENTER, LLC

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

## Provider details

- **NPI number:** 1851444079
- **Authorized official:** DR. TIMOTHY HALTERMAN M.D . (MEDICAL DIRECTOR)
- **Authorized official phone:** (775) 329-4600

## Contact information

- **Practice address:** 10619 PROFESSIONAL CIR, RENO, NV 89521-5831
- **Practice address phone:** (775) 852-4848
- **Practice address fax:** (775) 850-5763
- **Mailing address:** PO BOX 842681, LOS ANGELES, CA 90084-2660
- **Mailing address phone:** (775) 329-4600
- **Mailing address fax:** (775) 324-4314

## Taxonomy

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

## Other

- **Enumeration date:** 01/19/2007
- **Last updated:** 09/01/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100512981 | — | NV |