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General NPI Number Information
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NPI Number | 1639527278
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Entity Type | Organization
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Legal Business Name | RED ROCK PAIN SURGERY CENTER
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Dates
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Enumeration Date | 05/24/2016
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Last Update Date | 05/24/2016
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Provider Practice Location Address
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Address Line | 5915 S RAINBOW BLVD
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City | LAS VEGAS
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State | NV
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Zip | 89118-2557
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Country | US
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Telephone | 702-778-6003
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Fax | 702-851-0392
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Provider Business Mailing Address
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Address Line | 5915 S RAINBOW BLVD
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City | LAS VEGAS
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State | NV
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Zip | 89118-2557
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Country | US
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Telephone | 702-778-6003
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Fax | 702-851-0392
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Authorized Official
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Title or Position | CLINICAL COORDINATOR
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Name | MR. BILL SCHOONMAKER
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Credential | RN
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Telephone | 702-778-6003
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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 |
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License Number State |
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