Provider Demographics
NPI:1437145422
Name:WILLIAM BEE RIRIE HOSPITAL
Entity Type:Organization
Organization Name:WILLIAM BEE RIRIE HOSPITAL
Other - Org Name:WILLIAM BEE RIRIE HOSP CLINIC
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:F
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-289-3001
Mailing Address - Street 1:6 STEPTOE CIRCLE
Mailing Address - Street 2:WILLIAM BEE RIRIE HOSPITAL
Mailing Address - City:ELY
Mailing Address - State:NV
Mailing Address - Zip Code:89301
Mailing Address - Country:US
Mailing Address - Phone:775-289-3001
Mailing Address - Fax:775-289-6423
Practice Address - Street 1:6 STEPTOE CIRCLE
Practice Address - Street 2:
Practice Address - City:ELY
Practice Address - State:NV
Practice Address - Zip Code:89301
Practice Address - Country:US
Practice Address - Phone:775-289-3612
Practice Address - Fax:775-289-6423
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-23
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103T00000X, 207P00000X, 207Q00000X, 207R00000X, 207RR0500X, 363AM0700X
NV207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Multi-Specialty
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV01517887Medicaid
NVV33083Medicare PIN
NV01517887Medicaid