Provider Demographics
NPI:1407363070
Name:HIRK LLC
Entity Type:Organization
Organization Name:HIRK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:HIRSH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-371-1187
Mailing Address - Street 1:7220 MIRA VISTA ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89120-3025
Mailing Address - Country:US
Mailing Address - Phone:702-371-1187
Mailing Address - Fax:
Practice Address - Street 1:7220 MIRA VISTA ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-3025
Practice Address - Country:US
Practice Address - Phone:702-371-1187
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HIRK LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-01-04
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVFH6229682OtherDEA