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Organization

ALTA-ROSE SURGERY CENTER LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DOUGLAS K DEVRIES MD (OWNER)
(775) 674-1100
Entity
Organization

Contact information

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

Taxonomy

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

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100505697
NV
Enumeration date
03/21/2006
Last updated
11/28/2023
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