Provider Demographics
NPI:1104052406
Name:DIGNITY HEALTH
Entity type:Organization
Organization Name:DIGNITY HEALTH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:DEAKYNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-770-6239
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:775-828-7788
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:775-828-7788
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DIGNITY HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-06-02
Last Update Date:2012-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty