Healthcare Provider Details

I. General information

NPI: 1356526016
Provider Name (Legal Business Name): SPARKS FAMILY HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/31/2007
Last Update Date: 01/24/2022
Certification Date: 01/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2375 E PRATER WAY
SPARKS NV
89434-9641
US

IV. Provider business mailing address

FILE 50689
LOS ANGELES CA
90074-0001
US

V. Phone/Fax

Practice location:
  • Phone: 702-894-5700
  • Fax:
Mailing address:
  • Phone: 702-894-5700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246Z00000X
TaxonomyOther Specialist/Technologist
License Number653HOS-10
License Number StateNV

VIII. Authorized Official

Name: STEVE FILTON
Title or Position: CFO, SENIOR VP
Credential:
Phone: 610-768-3300