Healthcare Provider Details

I. General information

NPI: 1457592453
Provider Name (Legal Business Name): DESERT VIEW REGIONAL MEDICAL CENTER HOLDINGS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2009
Last Update Date: 03/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 S LOLA LN
PAHRUMP NV
89048
US

IV. Provider business mailing address

360 S LOLA LN
PAHRUMP NV
89048-0884
US

V. Phone/Fax

Practice location:
  • Phone: 775-751-7500
  • Fax: 775-751-7835
Mailing address:
  • Phone: 775-751-7500
  • Fax: 775-751-7835

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License Number4054HOS-1
License Number StateNV

VIII. Authorized Official

Name: MR. KEN M RICHENS
Title or Position: CFO
Credential:
Phone: 435-623-4924