Provider Demographics
NPI:1891799342
Name:COUNTY OF EUREKA
Entity Type:Organization
Organization Name:COUNTY OF EUREKA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:KENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-237-5306
Mailing Address - Street 1:PO BOX 407
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:NV
Mailing Address - Zip Code:89316-0407
Mailing Address - Country:US
Mailing Address - Phone:800-811-4045
Mailing Address - Fax:775-237-5614
Practice Address - Street 1:301 N MAIN STREET
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:NV
Practice Address - Zip Code:89316-1507
Practice Address - Country:US
Practice Address - Phone:775-237-7036
Practice Address - Fax:775-237-7037
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-10
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV071313416L0300X
NV073253416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1891799342Medicaid
CO43588824Medicaid
OK20099110AMedicaid
CAXMTE06564Medicaid
NV003206001Medicaid
NV=========OtherEUREKA COUNTY VOLUNTEER E