Provider Demographics
NPI:1730113465
Name:NEVADA HEALTH CENTERS INC
Entity Type:Organization
Organization Name:NEVADA HEALTH CENTERS INC
Other - Org Name:BRIDGER HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:G
Authorized Official - Last Name:CHASE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-887-1590
Mailing Address - Street 1:1802 N CARSON ST
Mailing Address - Street 2:STE 100
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89701-1227
Mailing Address - Country:US
Mailing Address - Phone:775-887-1590
Mailing Address - Fax:775-887-7047
Practice Address - Street 1:310 9TH ST
Practice Address - Street 2:STE 110
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89101
Practice Address - Country:US
Practice Address - Phone:702-220-9932
Practice Address - Fax:702-366-8642
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV261QF0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
291834Medicare Oscar/Certification
V33589Medicare PIN