1023402005 NPI number — PAMELA S HILL

Table of content: (NPI 1023402005)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023402005 NPI number — PAMELA S HILL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PAMELA S HILL
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:
1023402005
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/26/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11620 DEODAR WAY
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:
89506-9498
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
775-677-4417
Provider Business Mailing Address Fax Number:
775-677-4417

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
260 WONDER ST
Provider Second Line Business Practice Location Address:
#203
Provider Business Practice Location Address City Name:
RENO
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89502-2474
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
775-677-4417
Provider Business Practice Location Address Fax Number:
775-677-4417
Provider Enumeration Date:
03/26/2015

Additional Information

Authorized Official

Authorized Official Last Name:
HILL
Authorized Official First Name:
PAMELA
Authorized Official Middle Name:
S
Authorized Official Title or Position:
OWNER/.SOLE PROPRIETOR
Authorized Official Telephone Number:
775-677-4417

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  00129-L , 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)

  • Identifier: 1184854424 . This is a "WEST HILLS HOSPITAL PRIMARY EMPLOYER" identifier , issued by the state of ( NV ) . This identifiers is of the category "OTHER".




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