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General NPI Number Information
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NPI Number | 1104604636
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Entity Type | Organization
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Legal Business Name | RURAL CORRECTONAL HEALTH, LLC
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Dates
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Enumeration Date | 09/18/2023
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Last Update Date | 09/18/2023
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Provider Practice Location Address
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Address Line | 50 COMMERCIAL WAY
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City | FALLON
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State | NV
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Zip | 89406-2600
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Country | US
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Telephone | 775-455-4254
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Fax | 775-372-2163
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Provider Business Mailing Address
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Address Line | 50 COMMERCIAL WAY
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City | FALLON
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State | NV
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Zip | 89406-2600
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Country | US
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Telephone | 775-455-4254
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Fax | 775-372-2163
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Authorized Official
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Title or Position | OWNER
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Name | DR. JUSTIN HEATH
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Credential | DO
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Telephone | 775-685-9421
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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