Provider Demographics
NPI:1265519821
Name:SEVEN HILLS SURGERY CENTER LLC
Entity type:Organization
Organization Name:SEVEN HILLS SURGERY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BOARD/MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RUDY
Authorized Official - Middle Name:
Authorized Official - Last Name:MANTHEI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:702-589-4904
Mailing Address - Street 1:876 SEVEN HILLS DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-4369
Mailing Address - Country:US
Mailing Address - Phone:702-914-2028
Mailing Address - Fax:702-914-6290
Practice Address - Street 1:876 SEVEN HILLS DR
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-4369
Practice Address - Country:US
Practice Address - Phone:702-914-2028
Practice Address - Fax:702-914-6290
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2014-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV3496ASC-0261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV3496ASC-0OtherSTATE LICENSE