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Organization

FORT MCDERMITT WELLNESS CENTER

Active
Parent organization
FORT MCDERMITT PAIUTE SHOSHONE TRIBE
Organization subpart
Yes

Provider details

NPI number
Legal business name
FORT MCDERMITT PAIUTE SHOSHONE TRIBE
Authorized official
VALERIE BARR (CFO)
(775) 532-8259
Entity
Organization

Contact information

Practice address
112 NO RESERVATION RD, MCDERMITT, NV 89421-0315
(775) 532-8522
(775) 532-8024
Mailing address
112 NO RESERVATION RD, MCDERMITT, NV 89421-0315
(775) 532-8522
(775) 532-8024

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
APRN002392
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1043338593
NPI
NV
01
1053394866
NPI
CA
01
1104037704
NPI
CA
01
1386917011
NPI
NV
01
1518416577
NPI
NV
Enumeration date
11/04/2016
Last updated
11/04/2016
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