Healthcare Provider Details

I. General information

NPI: 1023071180
Provider Name (Legal Business Name): SAHARA OUTPATIENT SURGERY CENTER LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2006
Last Update Date: 02/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 PASEO DEL PRADO
LAS VEGAS NV
89102-4363
US

IV. Provider business mailing address

2401 PASEO DEL PRADO
LAS VEGAS NV
89102-4363
US

V. Phone/Fax

Practice location:
  • Phone: 702-362-7874
  • Fax: 702-362-3567
Mailing address:
  • Phone: 702-362-7874
  • Fax: 702-362-3567

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number466ASC10
License Number StateNV

VIII. Authorized Official

Name: WILLIAM GREGORY SWINNEY
Title or Position: VP
Credential:
Phone: 972-789-2877