Provider Demographics
NPI:1467558668
Name:RENOWN BUSINESSES
Entity Type:Organization
Organization Name:RENOWN BUSINESSES
Other - Org Name:BOUTIQUE AT RENOWN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO ACUTE CARE
Authorized Official - Prefix:MR
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-982-6343
Mailing Address - Street 1:75 PRINGLE WAY STE 107
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-8424
Mailing Address - Country:US
Mailing Address - Phone:775-982-5075
Mailing Address - Fax:775-982-5005
Practice Address - Street 1:75 PRINGLE WAY STE 107
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-8424
Practice Address - Country:US
Practice Address - Phone:775-982-5075
Practice Address - Fax:775-982-5005
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RENOWN BUSINESSES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-15
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVMP00115332B00000X
NV68527332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV0985060001Medicare NSC