Provider Demographics
NPI:1639527278
Name:RED ROCK PAIN SURGERY CENTER
Entity Type:Organization
Organization Name:RED ROCK PAIN SURGERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL COORDINATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BILL
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHOONMAKER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:702-778-6003
Mailing Address - Street 1:5915 S RAINBOW BLVD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89118-2557
Mailing Address - Country:US
Mailing Address - Phone:702-778-6003
Mailing Address - Fax:702-851-0392
Practice Address - Street 1:5915 S RAINBOW BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89118-2557
Practice Address - Country:US
Practice Address - Phone:702-778-6003
Practice Address - Fax:702-851-0392
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-24
Last Update Date:2016-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical