Provider Demographics
NPI:1063652931
Name:HORIZON HEALTHCARE PROFESSIONAL SERVICES LLC
Entity Type:Organization
Organization Name:HORIZON HEALTHCARE PROFESSIONAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SALMAN
Authorized Official - Middle Name:MUHAMMAD
Authorized Official - Last Name:MIRZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-644-9250
Mailing Address - Street 1:3015 HIGHWAY 95
Mailing Address - Street 2:SUITE 107
Mailing Address - City:BULLHEAD CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86442-4334
Mailing Address - Country:US
Mailing Address - Phone:702-644-9250
Mailing Address - Fax:702-644-9252
Practice Address - Street 1:3015 HIGHWAY 95
Practice Address - Street 2:SUITE 107
Practice Address - City:BULLHEAD CITY
Practice Address - State:AZ
Practice Address - Zip Code:86442-4334
Practice Address - Country:US
Practice Address - Phone:702-644-9250
Practice Address - Fax:702-644-9252
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-04
Last Update Date:2009-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV9290207RC0000X
247100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty