Basic Information
| Provider Information | |||||||||
| NPI: | 1437107752 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | PHILLIPS AND MILLER LTD | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | GERIATRIC CARE OF NEVADA | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 21609 | ||||||||
| Address2: | |||||||||
| City: | CARSON CITY | ||||||||
| State: | NV | ||||||||
| PostalCode: | 897211609 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7758842455 | ||||||||
| FaxNumber: | 7758830345 | ||||||||
| Practice Location | |||||||||
| Address1: | 5250 NEIL RD | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 895026555 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7758842455 | ||||||||
| FaxNumber: | 7758830345 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/05/2006 | ||||||||
| LastUpdateDate: | 08/09/2007 | ||||||||
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| AuthorizedOfficialLastName: | MURGUIA | ||||||||
| AuthorizedOfficialFirstName: | LISA | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | BILLING MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 7758842455 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0300X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Geriatric Medicine |
No ID Information.