Healthcare Provider Details

I. General information

NPI: 1598149106
Provider Name (Legal Business Name): VA HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2015
Last Update Date: 07/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8967 VIA VISTA CIR
LAS VEGAS NV
89147-6536
US

IV. Provider business mailing address

8967 VIA VISTA CIR
LAS VEGAS NV
89147-6536
US

V. Phone/Fax

Practice location:
  • Phone: 775-848-2371
  • Fax:
Mailing address:
  • Phone: 775-848-2371
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code286500000X
TaxonomyMilitary Hospital
License Number70303
License Number StateNV

VIII. Authorized Official

Name: SHEERY MARIE JABAT CALALO
Title or Position: REGISTERED NURSE
Credential:
Phone: 775-848-2371