Organization
LAS VEGAS EAST OPHTHALMOLOGY ASC LLC
Active
Other names
Shepherd Eye Surgicenter
Organization subpart
No
Provider details
NPI number
Authorized official
AMY GRIM (CREDENTIALING SPECIALIST)
(702) 202-4776
Entity
Organization
Contact information
Practice address
3575 PECOS MCLEOD, LAS VEGAS, NV 89121-3803
(702) 731-2088
(702) 734-7836
Mailing address
50 S STEPHANIE ST STE 101, HENDERSON, NV 89012-5731
(702) 202-4776
(702) 202-6110
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
485ASC-12
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4602450
—
NV
Enumeration date
02/08/2006
Last updated
09/07/2023
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