Provider Demographics
NPI:1821667973
Name:SUNRISE MOUNTAIN VIEW HOSPITAL, INC.
Entity Type:Organization
Organization Name:SUNRISE MOUNTAIN VIEW HOSPITAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:COVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-962-9005
Mailing Address - Street 1:3100 N TENAYA WAY
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-0436
Mailing Address - Country:US
Mailing Address - Phone:702-962-9005
Mailing Address - Fax:702-962-5508
Practice Address - Street 1:9860 WEST SKYE CANYON PARK DRIVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89166
Practice Address - Country:US
Practice Address - Phone:702-962-9005
Practice Address - Fax:702-962-5508
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUNRISE MOUNTAIN VIEW HOSPITAL, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-06-23
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1002006Medicaid
AKHS397IPMedicaid
NV001102006Medicaid
NV001202006Medicaid
CAXHSP42789Medicaid
AZ380329Medicaid
AKHS397OPMedicaid
CAXHSP32789Medicaid