1437145422 NPI number — WILLIAM BEE RIRIE HOSPITAL

Table of content: (NPI 1437145422)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437145422 NPI number — WILLIAM BEE RIRIE HOSPITAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WILLIAM BEE RIRIE HOSPITAL
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:
WILLIAM BEE RIRIE HOSP CLINIC
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:
1437145422
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/26/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6 STEPTOE CIRCLE
Provider Second Line Business Mailing Address:
WILLIAM BEE RIRIE HOSPITAL
Provider Business Mailing Address City Name:
ELY
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89301
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
775-289-3001
Provider Business Mailing Address Fax Number:
775-289-6423

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6 STEPTOE CIRCLE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ELY
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89301
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
775-289-3612
Provider Business Practice Location Address Fax Number:
775-289-6423
Provider Enumeration Date:
09/23/2005

Additional Information

Authorized Official

Authorized Official Last Name:
WALKER
Authorized Official First Name:
MATTHEW
Authorized Official Middle Name:
F.
Authorized Official Title or Position:
CHIEF EXECUTIVE OFFICER
Authorized Official Telephone Number:
775-289-3001

Provider Taxonomy Codes

  • Taxonomy code: 103T00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207P00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X , registered in the state of NV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RR0500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363AM0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 01517887 , issued by the state of ( NV ) . This identifiers is of the category "MEDICAID".




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