Provider Demographics
NPI:1558860890
Name:FKF GROUP HC LLC
Entity Type:Organization
Organization Name:FKF GROUP HC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLER
Authorized Official - Prefix:
Authorized Official - First Name:MORAG
Authorized Official - Middle Name:
Authorized Official - Last Name:BIALIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-932-0606
Mailing Address - Street 1:2865 SIENA HEIGHTS DR STE 120
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-4168
Mailing Address - Country:US
Mailing Address - Phone:702-776-7164
Mailing Address - Fax:
Practice Address - Street 1:2865 SIENA HEIGHTS DR
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-4167
Practice Address - Country:US
Practice Address - Phone:702-586-3211
Practice Address - Fax:702-586-4922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-01
Last Update Date:2018-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical