Organization
PRIME HEALTHCARE SERVICES NORTH VISTA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PREM REDDY (CHAIRMAN/PRESIDENT)
(909) 235-4400
Entity
Organization
Contact information
Practice address
1409 E LAKE MEAD BLVD, NORTH LAS VEGAS, NV 89030-7120
(702) 649-7711
Mailing address
1409 E LAKE MEAD BLVD, NORTH LAS VEGAS, NV 89030-7120
(702) 649-7711
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
649HOS-34
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100502299
—
NV
05
—
100502300
—
NV
05
—
100502301
—
NV
Enumeration date
12/02/2014
Last updated
12/02/2014
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