Healthcare Provider Details

I. General information

NPI: 1730739129
Provider Name (Legal Business Name): CARSON TAHOE REGIONAL HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2019
Last Update Date: 04/26/2022
Certification Date: 04/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 S CARSON ST
CARSON CITY NV
89701-5225
US

IV. Provider business mailing address

PO BOX 2168 1600 MEDICAL PARKWAY
CARSON CITY NV
89702-2168
US

V. Phone/Fax

Practice location:
  • Phone: 775-445-7330
  • Fax:
Mailing address:
  • Phone: 775-445-8672
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KATIE KUCERA
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 775-445-8672