Provider Demographics
NPI:1477701183
Name:HEALTHCARE PARTNERS MEDICAL GROUP (COATS), LTD.
Entity Type:Organization
Organization Name:HEALTHCARE PARTNERS MEDICAL GROUP (COATS), LTD.
Other - Org Name:INTERMOUNTAIN HEALTHCARE
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:H BARD
Authorized Official - Middle Name:
Authorized Official - Last Name:COATS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-216-3346
Mailing Address - Street 1:PO BOX 98978
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89193-8978
Mailing Address - Country:US
Mailing Address - Phone:702-216-3346
Mailing Address - Fax:702-617-6883
Practice Address - Street 1:6850 N. DURANGO DR.
Practice Address - Street 2:SUITE #120
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89149-4596
Practice Address - Country:US
Practice Address - Phone:702-735-7154
Practice Address - Fax:702-515-3599
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTHCARE PARTNERS MEDICAL GROUP (COATS) LTD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-09-05
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1043533383Medicaid
NV6894920007Medicare NSC
NVCQ328AMedicare PIN
NVVWCHKMMedicare PIN