Organization
STONECREEK SURGERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY GRIM (CREDENTIALING SPECIALIST)
(702) 202-4776
Entity
Organization
Contact information
Practice address
5915 S RAINBOW BLVD STE 108, LAS VEGAS, NV 89118-2558
(702) 227-7959
(702) 227-6344
Mailing address
2850 W HORIZON RIDGE PKWY STE 300, HENDERSON, NV 89052-4395
(702) 202-4776
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1417114166
—
NV
Enumeration date
05/20/2008
Last updated
03/11/2022
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