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628 Lake Street Reno NV 89501-1020 | |
| (775) 329-1717 | |
| (775) 329-2067 |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 628 Lake Street, Reno, Nevada |
| Authorized Official Name and Position | Philp A Rich (CEO) |
| Authorized Official Contact | 7753291717 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
628 Lake Street Reno NV 89501-1020 Ph: (775) 329-1717 | 628 Lake Street Reno NV 89501-1020 Ph: (775) 329-1717 |
| NPI Number | 1760663702 |
|---|---|
| Provider Enumeration Date | 11/19/2007 |
| Last Update Date | 08/23/2011 |
| Medicare PECOS PAC ID | 7810969649 |
|---|---|
| Medicare Enrollment ID | O20040811000653 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760663702 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 3995 (Nevada) | Primary |
| Provider Name | Philip A Rich |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1235108804 PECOS PAC ID: 1658541768 Enrollment ID: I20110906000056 |
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