Provider Demographics
NPI:1649497694
Name:COUNTY OF LANDER
Entity type:Organization
Organization Name:COUNTY OF LANDER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EMS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MIKEL
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-539-5971
Mailing Address - Street 1:50 STATE ROUTE 305
Mailing Address - Street 2:
Mailing Address - City:BATTLE MOUNTAIN
Mailing Address - State:NV
Mailing Address - Zip Code:89820-4300
Mailing Address - Country:US
Mailing Address - Phone:775-539-5971
Mailing Address - Fax:775-635-6153
Practice Address - Street 1:555 W HUMBOLDT ST
Practice Address - Street 2:
Practice Address - City:BATTLE MOUNTAIN
Practice Address - State:NV
Practice Address - Zip Code:89820-2668
Practice Address - Country:US
Practice Address - Phone:775-539-5971
Practice Address - Fax:775-635-6153
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3416L0300XTransportation ServicesAmbulanceLand TransportGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV0000PHGFCMedicare PIN