Healthcare Provider Details

I. General information

NPI: 1457291981
Provider Name (Legal Business Name): CARSON TAHOE REGIONAL HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2026
Last Update Date: 04/01/2026
Certification Date: 04/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 MEDICAL PKWY
CARSON CITY NV
89703-4625
US

IV. Provider business mailing address

1600 MEDICAL PKWY
CARSON CITY NV
89703-4625
US

V. Phone/Fax

Practice location:
  • Phone: 806-242-7782
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: KATIE KUCERA
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 775-445-5543