Healthcare Provider Details

I. General information

NPI: 1821667973
Provider Name (Legal Business Name): SUNRISE MOUNTAIN VIEW HOSPITAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2021
Last Update Date: 06/23/2021
Certification Date: 06/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9860 WEST SKYE CANYON PARK DRIVE
LAS VEGAS NV
89166
US

IV. Provider business mailing address

3100 N TENAYA WAY
LAS VEGAS NV
89128-0436
US

V. Phone/Fax

Practice location:
  • Phone: 702-962-9005
  • Fax: 702-962-5508
Mailing address:
  • Phone: 702-962-9005
  • Fax: 702-962-5508

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: MATTHEW COVA
Title or Position: CFO
Credential:
Phone: 702-962-9005