Provider Demographics
NPI:1659595460
Name:LINCOLN COUNTY HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:LINCOLN COUNTY HOSPITAL DISTRICT
Other - Org Name:GROVER C DILS MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:STARR
Authorized Official - Last Name:ROWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-726-8005
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 1:700 NORTH SPRING STREET
Practice Address - Street 2:
Practice Address - City:CALIENTE
Practice Address - State:NV
Practice Address - Zip Code:89008
Practice Address - Country:US
Practice Address - Phone:775-726-3171
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV643RUH-20275N00000X
NV643HOS 17282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
No282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV643HOS 17OtherSTATE LICENSE
NV643HOS 17OtherSTATE LICENSE
NV643HOS 17OtherSTATE LICENSE