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NPI Code Detail

MEDICARE: SAINT MARY'S MULTI-SPECIALTY CLINIC, INC.

MEDICARE: SAINT MARY'S MULTI-SPECIALTY CLINIC, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261Q00000XClinic/Center

General Provider Information

NPI Number : 1003120650
Entity Type Code : Organization
Provider Name (Legal Business Name) : SAINT MARY'S MULTI-SPECIALTY CLINIC, INC.
Provider Business Mailing Address
First Line : 645 N ARLINGTON AVE STE 555
Second Line :
City : RENO
State : NV
Zip : 89503-4452
Country : US
Telephone Number : 775-770-7661
Fax Number : 775-770-7368
Provider Business Practice Location Address
First Line : 5065 PYRAMID WAY
Second Line :
City : SPARKS
State : NV
Zip : 89436-7703
Country : US
Telephone Number : 775-770-7664
Fax Number : 775-770-7358
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : HOWARD RATTIGAN
Credential :
Telephone Number : 775-770-7044
Provider Enumeration Date : 08/05/2010
Last Update Date : 02/03/2012

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Directions to “SAINT MARY'S MULTI-SPECIALTY CLINIC, INC. ” Practice Location

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