Provider Demographics
NPI:1871202465
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:CONTRACT MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JO
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:CARDINAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-726-8012
Mailing Address - Street 1:PO BOX 1010
Mailing Address - Street 2:
Mailing Address - City:CALIENTE
Mailing Address - State:NV
Mailing Address - Zip Code:89008-1010
Mailing Address - Country:US
Mailing Address - Phone:775-726-3171
Mailing Address - Fax:775-726-3666
Practice Address - Street 1:700 N SPRING STREET
Practice Address - Street 2:
Practice Address - City:CALIENTE
Practice Address - State:NV
Practice Address - Zip Code:89008-1010
Practice Address - Country:US
Practice Address - Phone:775-726-3171
Practice Address - Fax:775-726-3666
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LINCOLN COUNTY HOSPITAL DISTRICT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-11-22
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVPH04333OtherNEVADA BOARD OF PHARMACY