Provider Demographics
NPI:1629166624
Name:AMBULATORY SURGICAL CENTER OF SOUTHERN NEVADA LLC
Entity Type:Organization
Organization Name:AMBULATORY SURGICAL CENTER OF SOUTHERN NEVADA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:J
Authorized Official - Last Name:NEMEC
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:702-952-1660
Mailing Address - Street 1:PO BOX 50785
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89016-0785
Mailing Address - Country:US
Mailing Address - Phone:702-952-1660
Mailing Address - Fax:702-952-1665
Practice Address - Street 1:6950 S CIMARRON ROAD
Practice Address - Street 2:SUITE 100
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113
Practice Address - Country:US
Practice Address - Phone:702-952-1660
Practice Address - Fax:702-952-1665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV5334ASC-0261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV100771Medicare PIN