Provider Demographics
NPI:1427491323
Name:IMMUNIZE NEVADA
Entity type:Organization
Organization Name:IMMUNIZE NEVADA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:S
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:775-870-4338
Mailing Address - Street 1:5250 NEIL RD STE 103
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-6546
Mailing Address - Country:US
Mailing Address - Phone:775-870-4338
Mailing Address - Fax:
Practice Address - Street 1:5250 NEIL RD STE 103
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-6546
Practice Address - Country:US
Practice Address - Phone:775-870-4338
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-10
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable