Basic Information
| Provider Information | |||||||||
| NPI: | 1740464528 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | NEVADA HEALTH CENTERS, INC. | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | AUSTIN MEDICAL CLINIC | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1802 N CARSON ST STE 100 | ||||||||
| Address2: | |||||||||
| City: | CARSON CITY | ||||||||
| State: | NV | ||||||||
| PostalCode: | 897011227 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7758886610 | ||||||||
| FaxNumber: | 7758877046 | ||||||||
| Practice Location | |||||||||
| Address1: | 121 MAIN STREET | ||||||||
| Address2: | |||||||||
| City: | AUSTIN | ||||||||
| State: | NV | ||||||||
| PostalCode: | 89310 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7759642222 | ||||||||
| FaxNumber: | 7759642232 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/28/2007 | ||||||||
| LastUpdateDate: | 12/28/2007 | ||||||||
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| AuthorizedOfficialLastName: | INGREY | ||||||||
| AuthorizedOfficialFirstName: | STEPHANIE | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | PHARMACIST | ||||||||
| AuthorizedOfficialTelephone: | 7758886610 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | RPH | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 3336C0002X | PH1212 | NV | Y | Suppliers | Pharmacy | Clinic Pharmacy |
No ID Information.