Organization
PARKWAY SURGERY CENTER, LLC.
Active
Other names
Parkway Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC BOON (OFFICER / AUTHORIZED OFFICIAL)
(480) 567-0269
Entity
Organization
Contact information
Practice address
100 N GREEN VALLEY PKWY, STE 125, HENDERSON, NV 89074-6392
(702) 616-4954
(702) 269-0436
Mailing address
100 N GREEN VALLEY PKWY, STE 125, HENDERSON, NV 89074-6392
(702) 616-4954
(702) 269-0436
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
2147ASC
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0046-02011
—
NV
01
—
10-6133
CSHCN
NV
01
—
490004254
RAILROAD MEDICARE
NV
01
—
NV1692
BCBS
NV
Enumeration date
06/09/2005
Last updated
09/17/2024
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