Healthcare Provider Details

I. General information

NPI: 1487648804
Provider Name (Legal Business Name): WILLIAM BEE RIRIE HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2005
Last Update Date: 03/12/2021
Certification Date: 03/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 AVENUE H
ELY NV
89301-2615
US

IV. Provider business mailing address

1500 AVENUE H
ELY NV
89301-2615
US

V. Phone/Fax

Practice location:
  • Phone: 775-289-3467
  • Fax: 775-289-8244
Mailing address:
  • Phone: 775-289-3467
  • Fax: 775-289-8244

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number670HOS-12
License Number StateNV
# 4
Primary TaxonomyN
Taxonomy Code284300000X
TaxonomySpecial Hospital
License Number
License Number State

VIII. Authorized Official

Name: MR. MATTHEW WALKER
Title or Position: CEO
Credential: PHARM D
Phone: 775-289-3001