Provider Demographics
NPI:1043200736
Name:SUMMERLIN HOSPITAL MEDICAL CENTER L L C
Entity Type:Organization
Organization Name:SUMMERLIN HOSPITAL MEDICAL CENTER L L C
Other - Org Name:SUMMERLIN HOSPITAL MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO, SENIOR VP
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:FILTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-768-3300
Mailing Address - Street 1:657 TOWN CENTER DRIVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89134-6367
Mailing Address - Country:US
Mailing Address - Phone:702-233-7000
Mailing Address - Fax:
Practice Address - Street 1:657 TOWN CENTER DRIVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89134-6367
Practice Address - Country:US
Practice Address - Phone:702-233-7000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-25
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV662HOS-21273Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV001202008Medicaid
NV001102008Medicaid
NV001202008Medicaid
NV001102008Medicaid