Provider Demographics
NPI:1376198028
Name:HENDERSON HOSPITAL
Entity Type:Organization
Organization Name:HENDERSON HOSPITAL
Other - Org Name:ER AT GREEN VALLEY RANCH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE VP-CFO
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:610-768-3482
Mailing Address - Street 1:8801 W SAHARA AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-5865
Mailing Address - Country:US
Mailing Address - Phone:702-780-2700
Mailing Address - Fax:
Practice Address - Street 1:2581 SAINT ROSE PKWY
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-7777
Practice Address - Country:US
Practice Address - Phone:702-780-2700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HENDERSON HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-08-08
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical ServicesGroup - Single Specialty