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General NPI Number Information
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NPI Number | 1841535317
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Entity Type | Organization
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Legal Business Name | IRENE BENN MEDICAL CENTER
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Dates
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Enumeration Date | 12/10/2012
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Last Update Date | 12/12/2022
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Provider Practice Location Address
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Address Line | 10 LINCOLN ST
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City | MOAPA
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State | NV
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Zip | 89025-0819
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Country | US
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Telephone | 775-784-5327
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 819
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City | MOAPA
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State | NV
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Zip | 89025-0819
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Country | US
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Telephone | 775-784-5327
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Fax |
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Authorized Official
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Title or Position | SUPERVISOR, PATIENT BUSINESS OFFICE
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Name | SKY RAINBOW BLACK ELK-VOLKMANN
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Credential |
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Telephone | 605-384-4844
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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