Healthcare Provider Details

I. General information

NPI: 1336274646
Provider Name (Legal Business Name): RENO-SPARKS TRIBAL HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2007
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1715 KUENZLI ST
RENO NV
89502-1117
US

IV. Provider business mailing address

1715 KUENZLI ST
RENO NV
89502-1117
US

V. Phone/Fax

Practice location:
  • Phone: 775-334-4317
  • Fax: 775-334-4354
Mailing address:
  • Phone: 775-334-4317
  • Fax: 775-334-4354

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332800000X
TaxonomyIndian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: AMBER PAGANO
Title or Position: PHARMACY DIRECTOR
Credential: PHARM.D.
Phone: 775-329-5162