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General NPI Number Information
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NPI Number | 1174708879
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Entity Type | Organization
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Legal Business Name | CARSON VALLEY HEALTH RURAL HEALTH CLINIC
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Dates
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Enumeration Date | 01/01/2008
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Last Update Date | 01/26/2026
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Provider Practice Location Address
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Address Line | 1520 VIRGINIA RANCH RD
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City | GARDNERVILLE
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State | NV
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Zip | 89410-5731
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Country | US
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Telephone | 775-782-1550
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Fax | 775-782-1513
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Provider Business Mailing Address
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Address Line | 1520 VIRGINIA RANCH RD
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City | GARDNERVILLE
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State | NV
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Zip | 89410-5731
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Country | US
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Telephone | 775-782-1550
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. JEFFREY PRATER
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Credential |
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Telephone | 775-782-1500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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