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General NPI Number Information
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NPI Number | 1366446189
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Entity Type | Organization
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Legal Business Name | PARKWAY SURGERY CENTER, LLC.
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Dates
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Enumeration Date | 06/09/2005
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Last Update Date | 09/17/2024
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Provider Practice Location Address
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Address Line | 100 N GREEN VALLEY PKWY STE 125
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City | HENDERSON
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State | NV
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Zip | 89074-6392
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Country | US
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Telephone | 702-616-4954
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Fax | 702-269-0436
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Provider Business Mailing Address
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Address Line | 100 N GREEN VALLEY PKWY STE 125
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City | HENDERSON
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State | NV
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Zip | 89074-6392
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Country | US
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Telephone | 702-616-4954
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Fax | 702-269-0436
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Authorized Official
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Title or Position | OFFICER / AUTHORIZED OFFICIAL
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Name | ERIC BOON
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Credential |
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Telephone | 480-567-0269
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 2147ASC
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License Number State | NV
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