Healthcare Provider Details

I. General information

NPI: 1720564024
Provider Name (Legal Business Name): PBS ANESTHESIA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2018
Last Update Date: 07/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7220 S CIMARRON RD STE 270
LAS VEGAS NV
89113-2160
US

IV. Provider business mailing address

3157 N RAINBOW BLVD # 518
LAS VEGAS NV
89108-4578
US

V. Phone/Fax

Practice location:
  • Phone: 702-912-4100
  • Fax: 702-386-4701
Mailing address:
  • Phone: 702-386-4700
  • Fax: 702-386-4701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: BETH JOHNSON
Title or Position: OWNER
Credential:
Phone: 702-386-4700