Healthcare Provider Details

I. General information

NPI: 1285020412
Provider Name (Legal Business Name): GARY STONE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2015
Last Update Date: 04/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1485 W 4TH ST TRLR 26
RENO NV
89503-5006
US

IV. Provider business mailing address

1485 W 4TH ST TRLR 26
RENO NV
89503-5006
US

V. Phone/Fax

Practice location:
  • Phone: 775-985-4838
  • Fax:
Mailing address:
  • Phone: 775-985-4838
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: GARY CHARLES STONE
Title or Position: CAREGIVER
Credential:
Phone: 775-685-4838