Provider Demographics
NPI:1891837753
Name:PERSHING COUNTY OFFICE OF AUDITOR
Entity Type:Organization
Organization Name:PERSHING COUNTY OFFICE OF AUDITOR
Other - Org Name:PERSHING COUNTY AMBULANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP BUSINESS OFFICE
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:WATANABE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-858-5700
Mailing Address - Street 1:PO BOX 820
Mailing Address - Street 2:
Mailing Address - City:LOVELOCK
Mailing Address - State:NV
Mailing Address - Zip Code:89419-0820
Mailing Address - Country:US
Mailing Address - Phone:775-353-0769
Mailing Address - Fax:775-353-0869
Practice Address - Street 1:1180 CORNELL AVE
Practice Address - Street 2:
Practice Address - City:LOVELOCK
Practice Address - State:NV
Practice Address - Zip Code:89419-8010
Practice Address - Country:US
Practice Address - Phone:775-353-0769
Practice Address - Fax:775-353-0869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2018-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV14106341600000X
341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV003214001Medicaid
NV0000RBBFSMedicare ID - Type UnspecifiedPROVIDER NUMBER
NVV0000RBBFSMedicare PIN