OrganizationProvider Network, Inc(<Unavail>)Family MedicineAllopathic & Osteopathic PhysiciansPractice Address1343 Newlands Dr W, Fernley, NV 89408-8926(775) 982-5000(775) 982-5262PECOS EnrollmentBased on the most recent information from CMS, provider Provider Network, Inc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 9:30 AM.Profile DetailsProvider ID1508811084Provider TypeOrganizationFull NameProvider Network, IncOther Name<Unavail>SubpartYesEnumeration Date5/23/2006Last Updated6/7/2024Contact InformationPractice LocationPractice Address1343 Newlands Dr W, Fernley, NV 89408-8926Phone(775) 982-5000Fax(775) 982-6504Mailing LocationMailing Address1155 Mill St # M14, Reno, NV 89502-1576Phone(775) 982-5262Fax(775) 982-5496Authorized OfficialNameMoore, Brett (Cfo Acute Care)Phone(775) 982-6343Provider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicenseUnlisted IssuerNevadaProvider IdentifiersIDDescriptionIssuerIDCG0436DescriptionOtherIssuerRR MEDICARE PTANNevada