Organization
SOUTH MEADOWS ENDOSCOPY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY HALTERMAN M.D . (MEDICAL DIRECTOR)
(775) 329-4600
Entity
Organization
Contact information
Practice address
10619 PROFESSIONAL CIR, RENO, NV 89521-5831
(775) 852-4848
(775) 850-5763
Mailing address
PO BOX 842681, LOS ANGELES, CA 90084-2660
(775) 329-4600
(775) 324-4314
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100512981
—
NV
Enumeration date
01/19/2007
Last updated
09/01/2022
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