Provider Demographics
NPI:1629492137
Name:215 SURGERY CENTER, LLC
Entity Type:Organization
Organization Name:215 SURGERY CENTER, LLC
Other - Org Name:215 SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HEATH
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-449-1912
Mailing Address - Street 1:6120 S FORT APACHE RD
Mailing Address - Street 2:STE. 200
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-6702
Mailing Address - Country:US
Mailing Address - Phone:702-948-8894
Mailing Address - Fax:702-948-8956
Practice Address - Street 1:6120 S FORT APACHE RD
Practice Address - Street 2:STE. 200
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-6702
Practice Address - Country:US
Practice Address - Phone:702-948-8894
Practice Address - Fax:702-948-8956
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-05
Last Update Date:2014-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical