Ft. Mcdermitt Paiute Shoshone Tribe

NPI #1316449291 in Mcdermitt, Nevada

Provider Information

NPI Number
1316449291
Entity Type
Organization
Organization Name
Ft. Mcdermitt Paiute Shoshone Tribe
Subpart
Yes (part of a larger organization)
Parent Organization
FT. MCDERMITT PAUITE-SHOSHONE TRIBE
Primary Specialty
Clinic/Center - Federally Qualified Health Center (FQHC)
Enumeration Date
Mar 6, 2018
Last Updated
Aug 30, 2022

Practice Location

Address
112 NORTH RESERVATION RD
State
Nevada
ZIP Code
89421-0315
Phone
(775) 532-8522

Authorized Official

Name
MR. FERGUS JOHN LAUGHRIDGE SR.
Title
HEALTH DIRECTOR
Phone
(775) 532-8522

Specialties & Taxonomy Codes

Specialty
Clinic/Center - Federally Qualified Health Center (FQHC)Federally Qualified Health Center (FQHC)

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