Healthcare Provider Details

I. General information

NPI: 1104700301
Provider Name (Legal Business Name): NGS2
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2025
Last Update Date: 09/18/2025
Certification Date: 09/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5401 LONGLEY LN STE 34
RENO NV
89511-1817
US

IV. Provider business mailing address

5401 LONGLEY LN STE 34
RENO NV
89511-1817
US

V. Phone/Fax

Practice location:
  • Phone: 775-453-0133
  • Fax:
Mailing address:
  • Phone: 775-453-0133
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: GARY BROOKS
Title or Position: OWNER
Credential:
Phone: 775-544-8873