Provider Demographics
NPI:1417320540
Name:SIERRA PEDIATRIC BLOOD AND CANCER CONSORTIUM
Entity Type:Organization
Organization Name:SIERRA PEDIATRIC BLOOD AND CANCER CONSORTIUM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO, AHN
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHERRI
Authorized Official - Middle Name:RAE
Authorized Official - Last Name:RICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-225-7839
Mailing Address - Street 1:75 PRINGLE WAY
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-1464
Mailing Address - Country:US
Mailing Address - Phone:775-284-1913
Mailing Address - Fax:775-432-1099
Practice Address - Street 1:75 PRINGLE WAY
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-1464
Practice Address - Country:US
Practice Address - Phone:775-284-8989
Practice Address - Fax:775-432-1099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-11
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-OncologyGroup - Multi-Specialty