Provider Demographics
NPI:1386055028
Name:DR. JOEL & CAROL BOWER SCHOOL BASED HEALTH CENTER
Entity type:Organization
Organization Name:DR. JOEL & CAROL BOWER SCHOOL BASED HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SHERRILYN
Authorized Official - Middle Name:
Authorized Official - Last Name:COFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-992-2045
Mailing Address - Street 1:400 PALO VERDE DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89015-6028
Mailing Address - Country:US
Mailing Address - Phone:702-799-0508
Mailing Address - Fax:702-799-0510
Practice Address - Street 1:400 PALO VERDE DR
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89015-6028
Practice Address - Country:US
Practice Address - Phone:702-799-0508
Practice Address - Fax:702-799-0510
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEVADA STATE COLLEGE FOUNDATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-05-15
Last Update Date:2014-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Single Specialty