Provider Demographics
NPI:1073224333
Name:SANTA ROSA MEDICAL CENTERS OF NEVADA, INC
Entity Type:Organization
Organization Name:SANTA ROSA MEDICAL CENTERS OF NEVADA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SYED
Authorized Official - Middle Name:IRSHAD
Authorized Official - Last Name:PERVAIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-268-8185
Mailing Address - Street 1:4161 S EASTERN AVE STE B3
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-5483
Mailing Address - Country:US
Mailing Address - Phone:702-693-6222
Mailing Address - Fax:702-369-6504
Practice Address - Street 1:3530 VOLUNTEER BLVD STE 100
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89044-1857
Practice Address - Country:US
Practice Address - Phone:702-268-8185
Practice Address - Fax:702-297-6163
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-07
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy