Provider Demographics
NPI:1215315973
Name:SOUTHERN NEVADA HEALTH DISTRICT
Entity type:Organization
Organization Name:SOUTHERN NEVADA HEALTH DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REVENUE CYCLE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:BUSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-759-0636
Mailing Address - Street 1:P O BOX 3902
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89127
Mailing Address - Country:US
Mailing Address - Phone:702-759-1000
Mailing Address - Fax:
Practice Address - Street 1:700 S MARTIN LUTHER KING BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-4409
Practice Address - Country:US
Practice Address - Phone:702-759-1000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOUTHERN NEVADA PUBLIC HEALTH LABORATORY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-05-14
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV3828PHL-7291U00000X
291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory