Healthcare Provider Details

I. General information

NPI: 1306070214
Provider Name (Legal Business Name): BATTLE MOUNTAIN GENERAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2009
Last Update Date: 03/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

535 S HUMBOLDT ST
BATTLE MOUNTAIN NV
89820-1988
US

IV. Provider business mailing address

535 S HUMBOLDT ST
BATTLE MOUNTAIN NV
89820-1988
US

V. Phone/Fax

Practice location:
  • Phone: 775-635-2550
  • Fax: 775-635-9463
Mailing address:
  • Phone: 775-635-2550
  • Fax: 775-635-9463

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number4872RHC-2
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number631HOS-16
License Number StateNV
# 3
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: JASON BLEAK
Title or Position: CEO
Credential:
Phone: 775-635-2550