MEDICARE: VALLEY VIEW SURGERY CENTER

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
1	261QA1903X	Ambulatory Surgical Clinic/Center

General Provider Information

NPI Number	:	1578570636
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VALLEY VIEW SURGERY CENTER

Provider Business Mailing Address
First Line	:	1330 S VALLEY VIEW BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102
Country	:	US
Telephone Number	:	702-870-7101
Fax Number	:	702-870-7118

Provider Business Practice Location Address
First Line	:	1330 S VALLEY VIEW BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102
Country	:	US
Telephone Number	:	702-870-7101
Fax Number	:	702-870-7118

Authorized Official
Title or Position	:	ADMINISTRATOR SUPERVISOR
Name	:	SUE MCCOURT
Credential	:
Telephone Number	:	702-870-7101

Provider Enumeration Date	:	08/02/2006
Last Update Date	:	08/22/2020

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