Healthcare Provider Details

I. General information

NPI: 1477559169
Provider Name (Legal Business Name): 7 HILLS RADIOLOGY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2005
Last Update Date: 06/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

870 SEVEN HILLS DR STE 101
HENDERSON NV
89052-4378
US

IV. Provider business mailing address

PO BOX 530326
HENDERSON NV
89053-0326
US

V. Phone/Fax

Practice location:
  • Phone: 702-932-9888
  • Fax: 702-932-9887
Mailing address:
  • Phone: 702-407-8647
  • Fax: 702-407-8649

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number0304250402
License Number StateNV

VIII. Authorized Official

Name: CHINASA O EGEMONU
Title or Position: PRESIDENT
Credential:
Phone: 702-407-8647