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General NPI Number Information
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NPI Number | 1285887091
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Entity Type | Organization
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Legal Business Name | CHW NEVADA IMAGING COMPANY LLC
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Dates
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Enumeration Date | 10/24/2008
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Last Update Date | 10/24/2008
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Provider Practice Location Address
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Address Line | 1818 E LAKE MEAD BLVD SUITE 113N
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89030-7100
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Country | US
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Telephone | 702-891-9729
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Fax |
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Provider Business Mailing Address
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Address Line | 5495 S RAINBOW BLVD SUITE 101
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City | LAS VEGAS
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State | NV
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Zip | 89118-1871
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Country | US
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Telephone | 702-317-1200
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ROD A. DAVIS
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Credential |
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Telephone | 702-616-5500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0206X
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Taxonomy Name | Mammography Clinic/Center
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License Number |
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License Number State |
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