Provider Demographics
NPI:1275199432
Name:LINCOLN COUNTY HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:LINCOLN COUNTY HOSPITAL DISTRICT
Other - Org Name:LINCOLN COUNTY MEDICAL ASSOCIATES ALAMO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:MRS
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:775-726-3797
Practice Address - Street 1:33 JOSHUA TREE ST
Practice Address - Street 2:
Practice Address - City:ALAMO
Practice Address - State:NV
Practice Address - Zip Code:89001
Practice Address - Country:US
Practice Address - Phone:775-725-3364
Practice Address - Fax:775-726-3797
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LINCOLN COUNTY HOSPITAL DISTRICT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-05-14
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1174602056Medicaid