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Organization
WASHOE TRIBE OF NEVADA AND CALIFORNIA
Active
Organization
WASHOE TRIBE OF NEVADA AND CALIFORNIA
Active
Other names
WASHOE TRIBAL HEALTH CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
LOREN ELLERY PHARM D (CLINIC DIRECTOR)
(775) 265-4215
Entity
Organization
Contact information
Practice address
1559 WATASHEAMU RD, GARDNERVILLE, NV 89460-7455
(775) 265-4215
(775) 265-6071
Mailing address
1559 WATASHEAMU RD, GARDNERVILLE, NV 89460-7455
(775) 265-4215
(775) 265-6071
Taxonomy
Speciality
Code
Description
License number
State
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Primary
—
—
333600000X
Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00470300
—
NV
05
—
004703001
—
NV
01
—
2056708
PK
—
Enumeration date
07/25/2006
Last updated
12/10/2014
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