Provider Demographics
NPI:1063622926
Name:WALKER RIVER PAIUTE TRIBE
Entity type:Organization
Organization Name:WALKER RIVER PAIUTE TRIBE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:HEALTH DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:B
Authorized Official - Last Name:MCAULIFFE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-773-2005
Mailing Address - Street 1:PO BOX C
Mailing Address - Street 2:
Mailing Address - City:SCHURZ
Mailing Address - State:NV
Mailing Address - Zip Code:89427-0502
Mailing Address - Country:US
Mailing Address - Phone:775-773-2005
Mailing Address - Fax:775-773-2012
Practice Address - Street 1:1025 HOSPITAL ROAD
Practice Address - Street 2:
Practice Address - City:SCHURZ
Practice Address - State:NV
Practice Address - Zip Code:89427-0502
Practice Address - Country:US
Practice Address - Phone:775-773-2005
Practice Address - Fax:775-773-2012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0904XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, Federal
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV004711030Medicaid