Healthcare Provider Details

I. General information

NPI: 1790851616
Provider Name (Legal Business Name): BATTLE MOUNTAIN GENERAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2006
Last Update Date: 10/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

535 S HUMBOLDT ST STE A
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: 775-635-8844
Mailing address:
  • Phone: 775-635-2550
  • Fax: 775-635-8844

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number631HOS-14
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number4213EXL-0
License Number StateNV
# 3
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number4872RHC-5
License Number StateNV

VIII. Authorized Official

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