Provider Demographics
NPI:1912285131
Name:SAINT MARY'S MULTI-SPECIALTY CLINIC, INC.
Entity Type:Organization
Organization Name:SAINT MARY'S MULTI-SPECIALTY CLINIC, INC.
Other - Org Name:SAINT MARY'S URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:HOWARD (CHIP)
Authorized Official - Middle Name:F
Authorized Official - Last Name:RATTIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-770-7044
Mailing Address - Street 1:645 N ARLINGTON AVE
Mailing Address - Street 2:SUITE 555
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89503-4460
Mailing Address - Country:US
Mailing Address - Phone:775-770-7348
Mailing Address - Fax:775-770-7368
Practice Address - Street 1:18653 WEDGE PKWY
Practice Address - Street 2:SUITE 300
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-3323
Practice Address - Country:US
Practice Address - Phone:775-770-7210
Practice Address - Fax:775-770-7211
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SAINT MARY'S MULTI-SPECIALTY CLINIC, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-07-22
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty