Healthcare Provider Details
I. General information
NPI: 1023054012
Provider Name (Legal Business Name): NHI-1
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/20/2006
Last Update Date: 06/07/2024
Certification Date: 06/07/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1500 EAST SECOND SUITE 400
RENO NV
89502-1198
US
IV. Provider business mailing address
1155 MILL ST # M14
RENO NV
89502-1576
US
V. Phone/Fax
- Phone: 775-982-2400
- Fax: 775-982-2888
- Phone: 775-982-5262
- Fax: 775-982-5496
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RC0000X |
| Taxonomy | Cardiovascular Disease Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RC0001X |
| Taxonomy | Clinical Cardiac Electrophysiology Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RI0011X |
| Taxonomy | Interventional Cardiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
BRETT
MOORE
Title or Position: CFO ACUTE CARE
Credential:
Phone: 775-982-6343