Provider Demographics
NPI:1851418354
Name:CRITICAL CARE ASSOCIATES INC
Entity Type:Organization
Organization Name:CRITICAL CARE ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-734-5050
Mailing Address - Street 1:794 VEGAS VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89109-1529
Mailing Address - Country:US
Mailing Address - Phone:702-734-5050
Mailing Address - Fax:702-731-9414
Practice Address - Street 1:794 VEGAS VALLEY DRIVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89109
Practice Address - Country:US
Practice Address - Phone:702-734-5050
Practice Address - Fax:702-731-9414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2009-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV7303207P00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002019722Medicaid
NVNEW NUMBER PENDINGMedicare ID - Type Unspecified
NV002019722Medicaid