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445 State Route 338 Wellington NV 89444-9711 | |
(775) 465-2587 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 445 State Route 338, Wellington, Nevada |
Authorized Official Name and Position | Kylee Fowler (MEDICAL STAFF COORDINATOR) |
Authorized Official Contact | 7754636491 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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213 S Whitacre St Yerington NV 89447-2561 Ph: (775) 463-2301 | 445 State Route 338 Wellington NV 89444-9711 Ph: (775) 465-2587 |
NPI Number | 1538129549 |
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Provider Enumeration Date | 03/24/2006 |
Last Update Date | 10/11/2023 |
Medicare PECOS PAC ID | 0648178533 |
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Medicare Enrollment ID | O20100423000326 |
Identifier | Type | State | Issuer |
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1538129549 | NPI | - | NPPES |
001510005 | Medicaid | NV |
Taxonomy | Type | License (State) | Status |
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208D00000X | General Practice | 3380RHC-5 (Nevada) | Secondary |
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |