Provider Demographics
NPI:1306070214
Name:BATTLE MOUNTAIN GENERAL HOSPITAL
Entity type:Organization
Organization Name:BATTLE MOUNTAIN GENERAL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:BLEAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-635-2550
Mailing Address - Street 1:535 S HUMBOLDT ST
Mailing Address - Street 2:
Mailing Address - City:BATTLE MOUNTAIN
Mailing Address - State:NV
Mailing Address - Zip Code:89820-1988
Mailing Address - Country:US
Mailing Address - Phone:775-635-2550
Mailing Address - Fax:775-635-9463
Practice Address - Street 1:535 S HUMBOLDT ST
Practice Address - Street 2:
Practice Address - City:BATTLE MOUNTAIN
Practice Address - State:NV
Practice Address - Zip Code:89820-1988
Practice Address - Country:US
Practice Address - Phone:775-635-2550
Practice Address - Fax:775-635-9463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-06
Last Update Date:2019-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4872RHC-2261QR1300X
NV631HOS-16282NC0060X
332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1013094010OtherNPI
NV1760569776OtherNPI
NV1245312321OtherNPI
NV1104903103OtherNPI
NV1366658809OtherNPI
NV1790851616OtherNPI
NV1487729083OtherNPI