Healthcare Provider Details

I. General information

NPI: 1225369473
Provider Name (Legal Business Name): DIGNITY HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2010
Last Update Date: 03/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 E WILLIAMS AVE SUITE 1101
FALLON NV
89406-3052
US

IV. Provider business mailing address

235 W 6TH ST
RENO NV
89503-4548
US

V. Phone/Fax

Practice location:
  • Phone: 775-327-8196
  • Fax:
Mailing address:
  • Phone: 775-770-3000
  • Fax: 775-770-4548

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number658HOS-20
License Number StateNV

VIII. Authorized Official

Name: JOHN DEAKYNE
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 775-770-6239