Provider Demographics
NPI:1023159829
Name:COUNTY OF ESMERALDA
Entity type:Organization
Organization Name:COUNTY OF ESMERALDA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COUNTY CLERK & TREASURER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LACINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:ELGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-485-6309
Mailing Address - Street 1:PO BOX 547
Mailing Address - Street 2:
Mailing Address - City:GOLDFIELD
Mailing Address - State:NV
Mailing Address - Zip Code:89013-0547
Mailing Address - Country:US
Mailing Address - Phone:775-485-6309
Mailing Address - Fax:775-485-6376
Practice Address - Street 1:233 CROOK STREET
Practice Address - Street 2:
Practice Address - City:GOLDFIELD
Practice Address - State:NV
Practice Address - Zip Code:89013
Practice Address - Country:US
Practice Address - Phone:775-485-6309
Practice Address - Fax:775-485-6376
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF ESMERALDA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-12
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV063453416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV=========Medicare PIN