Provider Demographics
NPI:1174602056
Name:LINCOLN COUNTY HOSPITAL DISTRICT
Entity type:Organization
Organization Name:LINCOLN COUNTY HOSPITAL DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-726-8005
Mailing Address - Street 1:33 JOSHUA TREE STREET
Mailing Address - Street 2:P.O. BOX 548
Mailing Address - City:ALAMO
Mailing Address - State:NV
Mailing Address - Zip Code:89001-0548
Mailing Address - Country:US
Mailing Address - Phone:775-725-3364
Mailing Address - Fax:
Practice Address - Street 1:33 JOSHUA TREE STREET
Practice Address - Street 2:
Practice Address - City:ALAMO
Practice Address - State:NV
Practice Address - Zip Code:89001
Practice Address - Country:US
Practice Address - Phone:775-725-3364
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LINCOLN COUNTY HOSPITAL DISTRICT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-03
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261Q00000X
NV643HOS 15261QF0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV643HOS 15OtherFACILITY LICENSE
NVVG29002708OtherCMS