Healthcare Provider Details

I. General information

NPI: 1902854516
Provider Name (Legal Business Name): COUNTY OF MINERAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 05/24/2021
Certification Date: 05/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

418 MINERAL WAY
HAWTHORNE NV
89415
US

IV. Provider business mailing address

PO BOX 1095
HAWTHORNE NV
89415-1095
US

V. Phone/Fax

Practice location:
  • Phone: 775-353-0769
  • Fax: 775-353-0869
Mailing address:
  • Phone: 775-353-0769
  • Fax: 775-353-0869

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number12122
License Number StateNV

VIII. Authorized Official

Name: CHRIS LAWRENCE
Title or Position: FIRE CHIEF
Credential:
Phone: 775-945-2497