Healthcare Provider Details

I. General information

NPI: 1194381889
Provider Name (Legal Business Name): CLOUDSKYWEST INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2019
Last Update Date: 10/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8455 S EASTERN AVE
LAS VEGAS NV
89123-2894
US

IV. Provider business mailing address

8455 S EASTERN AVE
LAS VEGAS NV
89123-2894
US

V. Phone/Fax

Practice location:
  • Phone: 702-333-0021
  • Fax:
Mailing address:
  • Phone: 702-333-0021
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: HUMAN RESOURCES
Title or Position: MEDICAL STAFF
Credential:
Phone: 702-333-0021