1427283860 NPI number — COMMUNITY HEALTH ALLIANCE

Table of content: (NPI 1427283860)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427283860 NPI number — COMMUNITY HEALTH ALLIANCE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COMMUNITY HEALTH ALLIANCE
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:
SUN VALLEY
Provider Other Organization Name Type Code:
5
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:
1427283860
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/25/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
680 S ROCK BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RENO
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89502-4113
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
775-336-3003
Provider Business Mailing Address Fax Number:
775-336-0653

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5055 SUN VALLEY BLVD STE 100
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SUN VALLEY
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89433-8296
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
775-870-4334
Provider Business Practice Location Address Fax Number:
775-870-4634
Provider Enumeration Date:
05/28/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
WHEELER
Authorized Official First Name:
JENNIFER
Authorized Official Middle Name:
Authorized Official Title or Position:
CCO
Authorized Official Telephone Number:
775-329-6300

Provider Taxonomy Codes

  • Taxonomy code: 261QF0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 100517814 , issued by the state of ( NV ) . This identifiers is of the category "MEDICAID".