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Organization

NA

Active
Parent organization
NA
Organization subpart
Yes

Provider details

NPI number
Legal business name
NA
Authorized official
NA NA (NA)
(408) 550-4200
Entity
Organization

Contact information

Practice address
215 E RAILROAD ST APT 1, WINNEMUCCA, NV 89445-3087
(408) 550-4200
Mailing address
215 E RAILROAD ST APT 1, WINNEMUCCA, NV 89445-3087
(408) 550-4200

Taxonomy

Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
19116
NV

Other

Enumeration date
03/28/2016
Last updated
03/28/2016
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