Provider Demographics
NPI:1013222090
Name:PRIME CARE NEVADA INC.
Entity Type:Organization
Organization Name:PRIME CARE NEVADA INC.
Other - Org Name:NYE REGIONAL MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:J
Authorized Official - Last Name:LATCHERAN
Authorized Official - Suffix:
Authorized Official - Credentials:N/A
Authorized Official - Phone:775-482-2460
Mailing Address - Street 1:PO BOX 391
Mailing Address - Street 2:
Mailing Address - City:TONOPAH
Mailing Address - State:NV
Mailing Address - Zip Code:89049-0391
Mailing Address - Country:US
Mailing Address - Phone:775-482-6233
Mailing Address - Fax:775-482-8272
Practice Address - Street 1:HWY 376
Practice Address - Street 2:
Practice Address - City:CARVERS
Practice Address - State:NV
Practice Address - Zip Code:89049
Practice Address - Country:US
Practice Address - Phone:775-482-6233
Practice Address - Fax:775-482-8272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-13
Last Update Date:2010-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty