Healthcare Provider Details

I. General information

NPI: 1619172129
Provider Name (Legal Business Name): LAS VEGAS HEARING CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2558 WIGWAM PKWY STE A
HENDERSON NV
89074-7103
US

IV. Provider business mailing address

6273 DEAN MARTIN DR
LAS VEGAS NV
89118-3833
US

V. Phone/Fax

Practice location:
  • Phone: 702-387-9688
  • Fax: 702-387-9690
Mailing address:
  • Phone: 702-616-1605
  • Fax: 702-616-0967

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number
License Number StateNV

VIII. Authorized Official

Name: MR. PHILLIP LEVILLIER
Title or Position: MANAGING MEMBER
Credential:
Phone: 702-387-9688