Paul Burch

Individual provider Active NPI Other Technician · Fallon, NV

NPI 1538554142 · NPPES record last updated Mar 31, 2015

Key facts

NPI
1538554142
Entity type
Individual (NPI type 1)
Primary specialty
Other Technician 247200000X
Practice address
1490 Grimes St
Fallon, NV 89406-3103
Phone
(775) 423-1412
Fax
(775) 423-4054
NPI assigned
Mar 31, 2015
Sex
Male
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Churchill Council on Alcohol & Other Drugs Past
since Mar 9, 2021
Accepting new patients
Churchill Council on Alcohol & Other Drugs Past
since Mar 21, 2021
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Other Technician 247200000X Yes

Addresses

Primary practice location

1490 Grimes St
Fallon, NV 89406-3103

Mailing address

PO Box 1240
Fallon, NV 89407-1240
Phone (775) 423-1412

Other providers in Fallon, NV

All providers in Fallon, NV · Other Technician in Nevada

Sources for this page

Verify at the official NPI Registry.