Provider Demographics
NPI:1063017606
Name:HO, WINSTON
Entity Type:Individual
Prefix:
First Name:WINSTON
Middle Name:
Last Name:HO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2333 RENO HWY
Mailing Address - Street 2:
Mailing Address - City:FALLON
Mailing Address - State:NV
Mailing Address - Zip Code:89406-6385
Mailing Address - Country:US
Mailing Address - Phone:775-428-1710
Mailing Address - Fax:
Practice Address - Street 1:2333 RENO HWY
Practice Address - Street 2:
Practice Address - City:FALLON
Practice Address - State:NV
Practice Address - Zip Code:89406-6385
Practice Address - Country:US
Practice Address - Phone:775-428-1710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-02
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV17489183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist