MEDICARE: BOULDER CITY HOSPITAL INC

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	261QR1300X	Rural Health Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811412497
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BOULDER CITY HOSPITAL INC

Provider Business Mailing Address
First Line	:	901 ADAMS BLVD
Second Line	:
City	:	BOULDER CITY
State	:	NV
Zip	:	89005-2213
Country	:	US
Telephone Number	:	702-293-4111
Fax Number	:	702-294-5732

Provider Business Practice Location Address
First Line	:	999 ADAMS BLVD
Second Line	:
City	:	BOULDER CITY
State	:	NV
Zip	:	89005-2244
Country	:	US
Telephone Number	:	702-293-4111
Fax Number	:	702-294-5732

Authorized Official
Title or Position	:	CFO
Name	:	MR. DOUGLAS B LEWIS
Credential	:
Telephone Number	:	702-293-4111

Provider Enumeration Date	:	08/04/2017
Last Update Date	:	02/14/2024

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Directions to “BOULDER CITY HOSPITAL INC ” Practice Location

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