Provider Demographics
NPI:1407405145
Name:SUNRISE MOUNTAIN VIEW HOSPITAL, INC.
Entity type:Organization
Organization Name:SUNRISE MOUNTAIN VIEW HOSPITAL, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:KILLIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-812-0525
Mailing Address - Street 1:3100 N TENAYA WAY
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-0436
Mailing Address - Country:US
Mailing Address - Phone:702-962-9005
Mailing Address - Fax:702-962-5508
Practice Address - Street 1:7207 ALIANTE PKWY
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89084-2373
Practice Address - Country:US
Practice Address - Phone:702-962-5100
Practice Address - Fax:702-962-5508
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUNRISE MOUNTAIN VIEW HOSPITAL, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-09-05
Last Update Date:2019-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ380329Medicaid
CAXHSP32789Medicaid
CAXHSP42789Medicaid
NV001202006Medicaid
AKHS397OPMedicaid
NV001102006Medicaid
NV1002006Medicaid
AKHS397IPMedicaid