Healthcare Provider Details

I. General information

NPI: 1023057478
Provider Name (Legal Business Name): FALLON TRIBAL HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2006
Last Update Date: 11/02/2021
Certification Date: 11/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 RIO VISTA DR
FALLON NV
89406-5463
US

IV. Provider business mailing address

1001 RIO VISTA DR
FALLON NV
89406-5463
US

V. Phone/Fax

Practice location:
  • Phone: 775-423-3634
  • Fax: 775-423-3246
Mailing address:
  • Phone: 775-423-3634
  • Fax: 775-423-2287

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code332800000X
TaxonomyIndian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. JON PISHION
Title or Position: HEALTH DIRECTOR
Credential:
Phone: 775-423-3634