Healthcare Provider Details

I. General information

NPI: 1114576857
Provider Name (Legal Business Name): SOUTHERN HILLS MEDICAL CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2019
Last Update Date: 09/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3325 S FORT APACHE RD
LAS VEGAS NV
89117-6360
US

IV. Provider business mailing address

9300 W SUNSET RD
LAS VEGAS NV
89148-4844
US

V. Phone/Fax

Practice location:
  • Phone: 702-962-0500
  • Fax: 702-916-9009
Mailing address:
  • Phone: 702-916-9002
  • Fax: 702-916-9009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0002X
TaxonomyEmergency Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER LE
Title or Position: CFO
Credential:
Phone: 702-916-9002