Healthcare Provider Details
I. General information
NPI: 1437185105
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: 06/24/2006
Last Update Date: 10/06/2020
Certification Date: 10/06/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
515 W HASKELL ST
WINNEMUCCA NV
89445-3782
US
IV. Provider business mailing address
5500 MARYLAND WAY STE 120
BRENTWOOD TN
37027-4993
US
V. Phone/Fax
- Phone: 775-625-4653
- Fax: 775-625-7004
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
STEVEN
A
HINITT
Title or Position: PRESIDENT
Credential: MD
Phone: 844-407-7557