Healthcare Provider Details

I. General information

NPI: 1649497694
Provider Name (Legal Business Name): COUNTY OF LANDER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2007
Last Update Date: 05/06/2024
Certification Date: 04/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 W HUMBOLDT ST
BATTLE MOUNTAIN NV
89820-2668
US

IV. Provider business mailing address

50 STATE ROUTE 305
BATTLE MOUNTAIN NV
89820-4300
US

V. Phone/Fax

Practice location:
  • Phone: 775-539-5971
  • Fax: 775-635-6153
Mailing address:
  • Phone: 775-539-5971
  • Fax: 775-635-6153

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: MIKEL RAY HARRIS
Title or Position: EMS DIRECTOR
Credential:
Phone: 775-539-5971