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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