Provider Demographics
NPI:1952796617
Name:LAS VEGAS - AMG SPECIALTY HOSPITAL, LLC
Entity Type:Organization
Organization Name:LAS VEGAS - AMG SPECIALTY HOSPITAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AUGUST
Authorized Official - Middle Name:J
Authorized Official - Last Name:RANTZ
Authorized Official - Suffix:IV
Authorized Official - Credentials:
Authorized Official - Phone:337-269-9566
Mailing Address - Street 1:101 LA RUE FRANCE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-3144
Mailing Address - Country:US
Mailing Address - Phone:337-269-9566
Mailing Address - Fax:337-234-1075
Practice Address - Street 1:4015 S. MCLEOD DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-4305
Practice Address - Country:US
Practice Address - Phone:702-433-2200
Practice Address - Fax:702-962-4435
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-31
Last Update Date:2016-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV292007Medicare Oscar/Certification