| Duckwater Shoshone Tribe | |
|
502 Duckwater Falls Rd Duckwater NV 89314-0087 | |
| (775) 863-0222 | |
| (775) 863-0142 |
| Full Name | Duckwater Shoshone Tribe |
|---|---|
| Speciality | Family Medicine |
| Location | 502 Duckwater Falls Rd, Duckwater, Nevada |
| Authorized Official Name and Position | Jerry Millett (TRIBAL MANAGER CHAIRMAN) |
| Authorized Official Contact | 7758630227 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Duckwater Shoshone Tribe Po Box 140087 Duckwater NV 89314-0087 Ph: (775) 863-0222 | Duckwater Shoshone Tribe 502 Duckwater Falls Rd Duckwater NV 89314-0087 Ph: (775) 863-0222 |
| NPI Number | 1144222761 |
|---|---|
| Provider Enumeration Date | 08/12/2005 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 2264424845 |
|---|---|
| Medicare Enrollment ID | O20040401001710 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144222761 | NPI | - | NPPES |
| 004712001 | Medicaid | NV | |
| 003112002 | Other | NV | HEALTHY KIDS SCREENING |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Nevada) | Primary |