Provider Demographics
NPI:1437546603
Name:SOLOMON'S PORCH
Entity type:Organization
Organization Name:SOLOMON'S PORCH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RENO OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMMONDS
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:775-337-9359
Mailing Address - Street 1:1280 TERMINAL WAY STE 3
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-3242
Mailing Address - Country:US
Mailing Address - Phone:775-337-9359
Mailing Address - Fax:775-867-5616
Practice Address - Street 1:1280 TERMINAL WAY STE 3
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-3242
Practice Address - Country:US
Practice Address - Phone:775-337-9359
Practice Address - Fax:775-867-5616
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-24
Last Update Date:2015-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service