Provider Demographics
NPI:1366658809
Name:BATTLE MOUNTAIN GENERAL HOSPITAL
Entity Type:Organization
Organization Name:BATTLE MOUNTAIN GENERAL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:BLEAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-635-2550
Mailing Address - Street 1:535 S HUMBOLDT ST
Mailing Address - Street 2:
Mailing Address - City:BATTLE MOUNTAIN
Mailing Address - State:NV
Mailing Address - Zip Code:89820-1988
Mailing Address - Country:US
Mailing Address - Phone:775-635-2550
Mailing Address - Fax:775-635-9463
Practice Address - Street 1:535 S HUMBOLDT ST
Practice Address - Street 2:
Practice Address - City:BATTLE MOUNTAIN
Practice Address - State:NV
Practice Address - Zip Code:89820-1988
Practice Address - Country:US
Practice Address - Phone:775-635-2550
Practice Address - Fax:775-635-9463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2019-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV631HOS9314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV295063Medicare Oscar/Certification
NVVB29001301Medicare PIN