Provider Demographics
NPI:1679524680
Name:HOLIDAY EQUIPMENT CORPORATION
Entity Type:Organization
Organization Name:HOLIDAY EQUIPMENT CORPORATION
Other - Org Name:CV IMAGING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:EUGENIA
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:775-342-6169
Mailing Address - Street 1:396 RUE DE LA OR
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89434-9521
Mailing Address - Country:US
Mailing Address - Phone:775-342-6169
Mailing Address - Fax:
Practice Address - Street 1:396 RUE DE LA OR
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89434-9521
Practice Address - Country:US
Practice Address - Phone:775-342-6169
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV69528335V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100217Medicare ID - Type Unspecified