Organization Name: | FALLON PAIUTE-SHOSHONE TRIBE |
NPI Number: | 1023057478 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOSEPH HERMAN (CLINIC DIRECTOR) |
Mailing Address: | 1001 Rio Vista Dr Fallon |
State: | NV US |
Postal Code: | 894065463 |
Phone Number: | 7754233634 |
Fax Number: | 7754233246 |
NPI Enumeration Date: | 06/04/2006 |
NPI Last Update Date: | 11/08/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332800000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy |
Taxonomy Specialization: | |
Taxonomy Definition: | An Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy means a pharmacy operated by the Indian Health Service, an Indian tribe or tribal organization, or an urban Indian organization, all of which are defined in Section 4 of the Indian Health Care Improvement Act, 25 U.S.C. 1603. |