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General NPI Number Information
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NPI Number | 1023599784
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Entity Type | Organization
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Legal Business Name | AMERICAN DIALYSIS CENTERS, NORTH LAS VEGAS LLC
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Dates
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Enumeration Date | 08/22/2018
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Last Update Date | 03/24/2021
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Provider Practice Location Address
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Address Line | 4107 W CHEYENNE AVE
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89032-3476
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Country | US
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Telephone | 702-383-9741
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Fax | 702-387-1145
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Provider Business Mailing Address
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Address Line | 900 S MAIN ST
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City | LAS VEGAS
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State | NV
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Zip | 89101-6425
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Country | US
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Telephone | 702-383-9741
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Fax | 702-387-1145
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Authorized Official
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Title or Position | MANAGER
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Name | CYRIL OVUWORIE
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Credential | M.D.
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Telephone | 702-232-1186
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0700X
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Taxonomy Name | End-Stage Renal Disease (ESRD) Treatment Clinic/Center
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License Number |
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License Number State |
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