Healthcare Provider Details

I. General information

NPI: 1558633933
Provider Name (Legal Business Name): HUMBOLDT GENERAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2012
Last Update Date: 08/08/2022
Certification Date: 08/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

118 E HASKELL ST
WINNEMUCCA NV
89445-3247
US

IV. Provider business mailing address

118 E HASKELL ST
WINNEMUCCA NV
89445-3247
US

V. Phone/Fax

Practice location:
  • Phone: 775-623-5222
  • Fax: 775-623-5904
Mailing address:
  • Phone: 775-623-5222
  • Fax: 775-623-5904

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number7415RHC-1
License Number StateNV

VIII. Authorized Official

Name: MRS. ROBYN DUNCKHORST
Title or Position: ADMINISTRATOR
Credential: RN
Phone: 775-623-5222