1285936351 NPI number — USPHS, INDIAN HEALTH SERVICE, SCHURZ

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285936351 NPI number — USPHS, INDIAN HEALTH SERVICE, SCHURZ

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
USPHS, INDIAN HEALTH SERVICE, SCHURZ
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1285936351
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/02/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1025 HOSPITAL ROAD
Provider Second Line Business Mailing Address:
DRAWER A
Provider Business Mailing Address City Name:
SCHURZ
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89427-0500
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
775-773-2345
Provider Business Mailing Address Fax Number:
775-773-2425

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
20 OLIVARRIA STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MCDERMITT
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89421
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
775-532-8530
Provider Business Practice Location Address Fax Number:
775-532-8531
Provider Enumeration Date:
11/23/2010

Additional Information

Authorized Official

Authorized Official Last Name:
MCAULIFFE
Authorized Official First Name:
ANDREW
Authorized Official Middle Name:
Authorized Official Title or Position:
ACTING CEO
Authorized Official Telephone Number:
775-773-2345

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  08410 , registered in the state of NV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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