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General NPI Number Information
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NPI Number | 1861637415
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Entity Type | Organization
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Legal Business Name | WASHOE TRIBE OF NEVADA AND CALIFORNIA
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Dates
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Enumeration Date | 12/11/2008
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Last Update Date | 02/18/2009
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Provider Practice Location Address
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Address Line | 1559 WATASHEAMU RD
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City | GARDNERVILLE
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State | NV
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Zip | 89460-7455
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Country | US
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Telephone | 775-265-4215
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Fax | 775-265-6071
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Provider Business Mailing Address
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Address Line | 1559 WATASHEAMU RD
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City | GARDNERVILLE
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State | NV
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Zip | 89460-7455
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Country | US
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Telephone | 775-265-4215
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Fax | 775-265-6071
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Authorized Official
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Title or Position | BUSINESS OFFICE MANAGER
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Name | MRS. CONNIE L SOUZA
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Credential |
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Telephone | 775-265-4215
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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