Provider Demographics
NPI:1740574086
Name:ELKO HEART INSTITUTE
Entity Type:Organization
Organization Name:ELKO HEART INSTITUTE
Other - Org Name:ELKO HEART PHYSICIANS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:T
Authorized Official - Last Name:BECK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-982-6488
Mailing Address - Street 1:1155 MILL ST # M14
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-1576
Mailing Address - Country:US
Mailing Address - Phone:775-982-5262
Mailing Address - Fax:775-982-4595
Practice Address - Street 1:1995 ERRECART BLVD
Practice Address - Street 2:STE 204
Practice Address - City:ELKO
Practice Address - State:NV
Practice Address - Zip Code:89801-8346
Practice Address - Country:US
Practice Address - Phone:775-738-0520
Practice Address - Fax:775-738-0104
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RENOWN HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-06-03
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVFQ971AMedicare PIN