Healthcare Provider Details

I. General information

NPI: 1376198028
Provider Name (Legal Business Name): HENDERSON HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2019
Last Update Date: 08/18/2022
Certification Date: 08/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2581 SAINT ROSE PKWY
HENDERSON NV
89074-7777
US

IV. Provider business mailing address

8801 W SAHARA AVE
LAS VEGAS NV
89117-5865
US

V. Phone/Fax

Practice location:
  • Phone: 702-780-2700
  • Fax:
Mailing address:
  • Phone: 702-780-2700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QE0002X
TaxonomyEmergency Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: STEVE FILTON
Title or Position: EXECUTIVE VP-CFO
Credential:
Phone: 610-768-3482