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General NPI Number Information
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NPI Number | 1538797485
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Entity Type | Organization
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Legal Business Name | NEVADA RURAL HEALTHCARE
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Dates
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Enumeration Date | 03/27/2020
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Last Update Date | 03/27/2020
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Provider Practice Location Address
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Address Line | 5785 S FORT APACHE RD STE B-100
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City | LAS VEGAS
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State | NV
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Zip | 89148-5659
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Country | US
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Telephone | 702-822-2273
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Fax |
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Provider Business Mailing Address
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Address Line | 1390 AVENUE L
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City | ELY
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State | NV
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Zip | 89301-2821
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Country | US
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Telephone | 518-796-3714
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Fax |
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Authorized Official
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Title or Position | CHIEF MEDICAL DIRECTOR
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Name | DR. ZIA KHAN
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Credential | MD
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Telephone | 702-822-2273
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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