Healthcare Provider Details

I. General information

NPI: 1811668072
Provider Name (Legal Business Name): PREMISE HEALTH OF NEVADA MEDICAL HINITT P C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2021
Last Update Date: 09/27/2021
Certification Date: 09/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

190 W 6TH ST
RENO NV
89503-4502
US

IV. Provider business mailing address

5500 MARYLAND WAY
BRENTWOOD TN
37027-7048
US

V. Phone/Fax

Practice location:
  • Phone: 775-328-9220
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State

VIII. Authorized Official

Name: STEVEN ASHLEY HINITT
Title or Position: PRESIDENT
Credential:
Phone: 210-563-5077