Provider Demographics
NPI:1225673791
Name:LINCOLN COUNTY HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:LINCOLN COUNTY HOSPITAL DISTRICT
Other - Org Name:GROVER C. DILS MEDICAL CENTER OUTPATIENT REHABILITATION CLINIC- ALAMO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:STARR
Authorized Official - Last Name:ROWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-726-8105
Mailing Address - Street 1:PO BOX 1010
Mailing Address - Street 2:
Mailing Address - City:CALIENTE
Mailing Address - State:NV
Mailing Address - Zip Code:89008-1010
Mailing Address - Country:US
Mailing Address - Phone:775-726-3171
Mailing Address - Fax:775-726-3118
Practice Address - Street 1:2 BROADWAY
Practice Address - Street 2:
Practice Address - City:ALAMO
Practice Address - State:NV
Practice Address - Zip Code:89001
Practice Address - Country:US
Practice Address - Phone:775-725-3710
Practice Address - Fax:775-726-3118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-08
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVNV201614423939OtherSTATE OF NV BUSINESS IDENTIFICATION