Provider Demographics
NPI:1467821264
Name:LANDERS INTENSIVE CARE SERVICES, LTD
Entity Type:Organization
Organization Name:LANDERS INTENSIVE CARE SERVICES, LTD
Other - Org Name:SHARON LANDERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:LANDERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-734-5050
Mailing Address - Street 1:2879 GEARY PL UNIT 2811
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89109-0218
Mailing Address - Country:US
Mailing Address - Phone:702-734-5050
Mailing Address - Fax:702-731-9414
Practice Address - Street 1:2879 GEARY PL UNIT 2811
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89109-0218
Practice Address - Country:US
Practice Address - Phone:702-734-5050
Practice Address - Fax:702-731-9414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-22
Last Update Date:2015-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV7303207RC0200X, 207RP1001X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1184693962OtherINDIVIDUAL NPI
NV002019722Medicaid
NV002019722Medicaid