Provider Demographics
NPI:1861645780
Name:CHW NEVADA IMAGING COMPANY LLC
Entity Type:Organization
Organization Name:CHW NEVADA IMAGING COMPANY LLC
Other - Org Name:NEVADA IMAGING CENTERS--SIENA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROD
Authorized Official - Middle Name:A
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-616-5500
Mailing Address - Street 1:2835 S JONES BLVD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-5354
Mailing Address - Country:US
Mailing Address - Phone:702-597-1145
Mailing Address - Fax:
Practice Address - Street 1:861 CORONADO CENTER DR
Practice Address - Street 2:SUITE 101
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-3992
Practice Address - Country:US
Practice Address - Phone:702-968-9729
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-23
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0206XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mammography
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVP00731251OtherRAILROAD
NVBW391AMedicare PIN