Healthcare Provider Details

I. General information

NPI: 1760517635
Provider Name (Legal Business Name): UNIVERSITY MEDICAL CENTER OF SOUTHERN NEVADA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 W CHARLESTON BLVD
LAS VEGAS NV
89102-2329
US

IV. Provider business mailing address

1800 W CHARLESTON BLVD
LAS VEGAS NV
89102-2329
US

V. Phone/Fax

Practice location:
  • Phone: 702-383-2619
  • Fax: 702-383-7335
Mailing address:
  • Phone: 702-383-2619
  • Fax: 702-383-7335

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License NumberPH0646
License Number StateNV

VIII. Authorized Official

Name: KATHLEEN SILVER
Title or Position: CEO
Credential:
Phone: 702-383-3860