Provider Demographics
NPI:1821755869
Name:CHMM ELKO MSO LLC
Entity Type:Organization
Organization Name:CHMM ELKO MSO LLC
Other - Org Name:ELKO COMMUNITY PHYSICIANS GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:GREER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-389-5777
Mailing Address - Street 1:222 S MERAMEC AVE STE 202-1002
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63105-1805
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2102 IDAHO STREET
Practice Address - Street 2:
Practice Address - City:ELKO
Practice Address - State:NV
Practice Address - Zip Code:89801
Practice Address - Country:US
Practice Address - Phone:775-389-5777
Practice Address - Fax:775-360-3602
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHMM ELKO MSO LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-11-24
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty