| |
3031 W Horizon Ridge Pkwy Ste 120 Henderson NV 89052-3809 | |
(702) 614-4476 | |
(702) 914-7644 |
Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 3031 W Horizon Ridge Pkwy Ste 120, Henderson, Nevada |
Authorized Official Name and Position | Monica Jayne Wall (PRESIDENT) |
Authorized Official Contact | 7026144476 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Po Box 530245 Henderson NV 89053-0245 Ph: (702) 614-4476 | 3031 W Horizon Ridge Pkwy Ste 120 Henderson NV 89052-3809 Ph: (702) 614-4476 |
NPI Number | 1457542961 |
---|---|
Provider Enumeration Date | 08/08/2007 |
Last Update Date | 03/31/2020 |
Medicare PECOS PAC ID | 0042340960 |
---|---|
Medicare Enrollment ID | O20100618000619 |
Identifier | Type | State | Issuer |
---|---|---|---|
1457542961 | NPI | - | NPPES |
002002422 | Medicaid | NV |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | 8291 (Nevada) | Primary |
Provider Name | Monica J Wall |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1942307855 PECOS PAC ID: 1153451083 Enrollment ID: I20100618000735 |
Siena Hills Primary Care Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2789 Sunridge Heights Pkwy, Suite 100, Henderson, NV 89052 Phone: 702-614-0850 Fax: 702-614-0798 | |
The Doc's Primary Care, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3005 W Horizon Ridge Pkwy Ste 100, Henderson, NV 89052 Phone: 702-997-7600 | |
Mark Day, D.o., Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 56 N Pecos Rd Ste A, Henderson, NV 89074 Phone: 702-456-9100 Fax: 702-434-7354 |