Healthcare Provider Details

I. General information

NPI: 1902408024
Provider Name (Legal Business Name): EDS-I HOMANSKY PRACTICES OF NEVADA PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2020
Last Update Date: 09/10/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6500 LONGLEY LN
RENO NV
89511-2632
US

IV. Provider business mailing address

PO BOX 99109
LAS VEGAS NV
89193-9109
US

V. Phone/Fax

Practice location:
  • Phone: 954-939-5000
  • Fax:
Mailing address:
  • Phone: 954-939-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: EDWIN HOMANSKY
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 469-401-2386