Healthcare Provider Details

I. General information

NPI: 1154794121
Provider Name (Legal Business Name): SURGCARE NETWORK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/12/2015
Last Update Date: 11/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

966 ASPEN CIR
FALLON NV
89406-2887
US

IV. Provider business mailing address

966 ASPEN CIR
FALLON NV
89406-2887
US

V. Phone/Fax

Practice location:
  • Phone: 775-427-8340
  • Fax:
Mailing address:
  • Phone: 775-427-8340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. SHELLEY SCHAFER
Title or Position: OWNER
Credential:
Phone: 775-427-8340