Healthcare Provider Details

I. General information

NPI: 1366658809
Provider Name (Legal Business Name): BATTLE MOUNTAIN GENERAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2007
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 TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number631HOS9
License Number StateNV

VIII. Authorized Official

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