Healthcare Provider Details

I. General information

NPI: 1851658025
Provider Name (Legal Business Name): PRIME HEALTHCARE SERVICES RENO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2012
Last Update Date: 11/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 W 6TH ST
RENO NV
89503-4548
US

IV. Provider business mailing address

235 W 6TH ST
RENO NV
89503-4548
US

V. Phone/Fax

Practice location:
  • Phone: 775-770-3000
  • Fax:
Mailing address:
  • Phone: 775-770-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License Number
License Number StateNV

VIII. Authorized Official

Name: RADHA A. SAVITALA
Title or Position: DEPUTY GENERAL COUNSEL
Credential:
Phone: 909-235-4308