Healthcare Provider Details
I. General information
NPI: 1134949605
Provider Name (Legal Business Name): AFFINITY HEALTH ELKO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/10/2024
Last Update Date: 10/10/2024
Certification Date: 10/10/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2102 IDAHO ST
ELKO NV
89801-2625
US
IV. Provider business mailing address
2102 IDAHO ST
ELKO NV
89801-2625
US
V. Phone/Fax
- Phone: 775-389-5778
- Fax: 775-460-2368
- Phone: 775-389-5778
- Fax: 775-460-2368
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM1300X |
| Taxonomy | Multi-Specialty Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
ANGELA
RENEE
BROWNING
Title or Position: BUSINESS OFFICE MANAGER
Credential: CCS
Phone: 775-340-9600