Healthcare Provider Details

I. General information

NPI: 1104604636
Provider Name (Legal Business Name): RURAL CORRECTONAL HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2023
Last Update Date: 09/18/2023
Certification Date: 09/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 COMMERCIAL WAY
FALLON NV
89406-2600
US

IV. Provider business mailing address

50 COMMERCIAL WAY
FALLON NV
89406-2600
US

V. Phone/Fax

Practice location:
  • Phone: 775-455-4254
  • Fax: 775-372-2163
Mailing address:
  • Phone: 775-455-4254
  • Fax: 775-372-2163

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JUSTIN HEATH
Title or Position: OWNER
Credential: DO
Phone: 775-685-9421