Healthcare Provider Details

I. General information

NPI: 1184476145
Provider Name (Legal Business Name): SOUTHERN HILLS MEDICAL CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2024
Last Update Date: 04/03/2024
Certification Date: 04/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9075 BLUE DIAMOND ROAD
LAS VEGAS NV
89178
US

IV. Provider business mailing address

9300 W SUNSET RD
LAS VEGAS NV
89148-4844
US

V. Phone/Fax

Practice location:
  • Phone: 702-916-5000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: SONIA BAUGHMAN
Title or Position: CFO
Credential:
Phone: 702-916-9002