MEDICARE: SUNSET SURGERY CENTER, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA1903X	Ambulatory Surgical Clinic/Center

General Provider Information

NPI Number	:	1801192059
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNSET SURGERY CENTER, LLC

Provider Business Mailing Address
First Line	:	9120 W RUSSELL RD
Second Line	:	SUITE #100
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-1229
Country	:	US
Telephone Number	:	702-476-2897
Fax Number	:	702-685-6910

Provider Business Practice Location Address
First Line	:	9120 W RUSSELL RD
Second Line	:	SUITE #100
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-1229
Country	:	US
Telephone Number	:	702-476-2897
Fax Number	:	702-685-6910

Authorized Official
Title or Position	:	PRACTICE MANAGER
Name	:	CATHERINE L MCDONALD
Credential	:	PRACTICE MANAGER
Telephone Number	:	702-262-0079

Provider Enumeration Date	:	02/07/2011
Last Update Date	:	01/12/2017

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