Provider Demographics
NPI:1366586463
Name:PRIMARY CARE PLUS FOUNDATION
Entity type:Organization
Organization Name:PRIMARY CARE PLUS FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PA-C
Authorized Official - Prefix:
Authorized Official - First Name:INEKE
Authorized Official - Middle Name:
Authorized Official - Last Name:GLAVOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-770-3780
Mailing Address - Street 1:3915 NEIL RD
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-6808
Mailing Address - Country:US
Mailing Address - Phone:775-770-3780
Mailing Address - Fax:
Practice Address - Street 1:3915 NEIL RD
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-6808
Practice Address - Country:US
Practice Address - Phone:775-770-3780
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV 305261QC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health