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NPI Code Detail

MEDICARE: PAM SPECIALTY HOSPITAL OF LAS VEGAS LLC

MEDICARE: PAM SPECIALTY HOSPITAL OF LAS VEGAS LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1282E00000XLong Term Care Hospital

General Provider Information

NPI Number : 1154978930
Entity Type Code : Organization
Provider Name (Legal Business Name) : PAM SPECIALTY HOSPITAL OF LAS VEGAS LLC
Provider Business Mailing Address
First Line : 1828 GOOD HOPE RD
Second Line :
City : ENOLA
State : PA
Zip : 17025-1203
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2500 N TENAYA WAY
Second Line :
City : LAS VEGAS
State : NV
Zip : 89128-0482
Country : US
Telephone Number : 702-562-2021
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : ANTHONY MISITANO
Credential :
Telephone Number : 717-731-9660
Provider Enumeration Date : 08/26/2019
Last Update Date : 08/03/2023

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Directions to “PAM SPECIALTY HOSPITAL OF LAS VEGAS LLC ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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