Healthcare Provider Details

I. General information

NPI: 1982524450
Provider Name (Legal Business Name): MT GRANT GENERAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 S MAIN ST
TONOPAH NV
89049-1599
US

IV. Provider business mailing address

PO BOX 1510
HAWTHORNE NV
89415-1510
US

V. Phone/Fax

Practice location:
  • Phone: 775-945-2461
  • Fax:
Mailing address:
  • Phone: 775-945-2461
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: SANDI LEHMAN
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 775-945-2461