| South Lyon Medical Center | |
|
445 State Route 338 Wellington NV 89444-9711 | |
| (775) 465-2587 | |
| Not Available |
| Full Name | South Lyon Medical Center |
|---|---|
| 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 |
|---|---|
| South Lyon Medical Center 213 S Whitacre St Yerington NV 89447-2561 Ph: (775) 463-2301 | South Lyon Medical Center 445 State Route 338 Wellington NV 89444-9711 Ph: (775) 465-2587 |
| NPI Number | 1538129549 |
|---|---|
| Provider Enumeration Date | 03/24/2006 |
| Last Update Date | 10/11/2023 |
| Medicare PECOS PAC ID | 0648178533 |
|---|---|
| Medicare Enrollment ID | O20100423000326 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538129549 | NPI | - | NPPES |
| 001510005 | Medicaid | NV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 3380RHC-5 (Nevada) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Topaz Ranch Medical Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3919 Carter Drive, Wellington, NV 89444 Phone: 775-783-3096 Fax: 775-266-4074 |