Provider Demographics
NPI:1255360160
Name:CARSON TAHOE REGIONAL HEALTHCARE
Entity type:Organization
Organization Name:CARSON TAHOE REGIONAL HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:
Authorized Official - Last Name:KUCERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-445-8672
Mailing Address - Street 1:PO BOX 2168
Mailing Address - Street 2:1600 MEDICAL PARKWAY
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89702-2168
Mailing Address - Country:US
Mailing Address - Phone:775-445-8672
Mailing Address - Fax:775-445-3200
Practice Address - Street 1:1600 MEDICAL PKWY
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89703-4625
Practice Address - Country:US
Practice Address - Phone:775-445-8672
Practice Address - Fax:775-445-3200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-02
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV635HOS13282N00000X
NV4466HOS4282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV001113843Medicaid
NV001013843Medicaid
NV001213843Medicaid