Healthcare Provider Details

I. General information

NPI: 1972857779
Provider Name (Legal Business Name): SAINT MARY'S HEALTH PLANS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2012
Last Update Date: 10/31/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1625 E PRATER WAY SUITE 102
SPARKS NV
89434-8969
US

IV. Provider business mailing address

1625 E PRATER WAY SUITE 102
SPARKS NV
89434-8969
US

V. Phone/Fax

Practice location:
  • Phone: 775-770-6210
  • Fax: 775-352-6616
Mailing address:
  • Phone: 775-770-6210
  • Fax: 775-352-6616

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. AMY KHAN
Title or Position: CHIEF MEDICAL OFFICER
Credential: M.D.
Phone: 775-770-6511