Provider Demographics
NPI:1720037799
Name:NORTH VISTA HOSPITAL LLC
Entity Type:Organization
Organization Name:NORTH VISTA HOSPITAL LLC
Other - Org Name:NORTH VISTA HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING ASSOCIATE GENERAL COUNSEL
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:DOAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-259-4706
Mailing Address - Street 1:1409 E LAKE MEAD BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89030-7120
Mailing Address - Country:US
Mailing Address - Phone:702-649-7711
Mailing Address - Fax:
Practice Address - Street 1:1409 E LAKE MEAD BLVD
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89030-7120
Practice Address - Country:US
Practice Address - Phone:702-649-7711
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-08
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV649HOS12282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0381966Medicaid
NV100502299Medicaid
NV100502300Medicaid
OK2000051340AMedicaid
FL913275900Medicaid
KS200327790AMedicaid
CO33224871Medicaid
NM48475254Medicaid
CAXHSP33711Medicaid
NV100502301Medicaid
LA1704989Medicaid
NC2900005Medicaid
AZ645868Medicaid
IA807122600Medicaid
MI304744870Medicaid
CAXHSP43711Medicaid
MI752632600Medicaid
NM48475254Medicaid
NV290005Medicare Oscar/Certification
V100467Medicare PIN