Healthcare Provider Details

I. General information

NPI: 1952049132
Provider Name (Legal Business Name): SPARKS FAMILY HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2022
Last Update Date: 05/26/2022
Certification Date: 05/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1511 OPPIO RANCH PKWY
SPARKS NV
89436
US

IV. Provider business mailing address

2700 FIRE MESA ST
LAS VEGAS NV
89128-9005
US

V. Phone/Fax

Practice location:
  • Phone: 702-369-7671
  • Fax:
Mailing address:
  • Phone: 702-369-7671
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0002X
TaxonomyEmergency Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: STEVE FILTON
Title or Position: EXECUTIVE VP-CFO
Credential:
Phone: 610-768-3482