Healthcare Provider Details

I. General information

NPI: 1669490603
Provider Name (Legal Business Name): PERSHING GENERAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 12/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

855 6TH ST.
LOVELOCK NV
89419-0661
US

IV. Provider business mailing address

PO BOX 661 855 6TH STREET
LOVELOCK NV
89419-0661
US

V. Phone/Fax

Practice location:
  • Phone: 775-273-2621
  • Fax: 775-273-5183
Mailing address:
  • Phone: 775-273-2621
  • Fax: 775-273-5183

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number655HOS-11
License Number StateNV

VIII. Authorized Official

Name: MS. CYNTHIA HIXENBAUGH
Title or Position: CEO
Credential:
Phone: 775-273-2621