County of Mineral – Land Ambulance in Hawthorne, NV

Key facts

NPI: 1902854516
Entity type: Organization (NPI type 2)
Primary specialty: Land Ambulance 3416L0300X
License: 12122 (NV)
Legal business name: COUNTY OF MINERAL
Practice address: 418 Mineral Way
Hawthorne, NV 89415
Phone: (775) 353-0769
Fax: (775) 353-0869
NPI assigned: May 5, 2006
Organization subpart: No

Authorized official

Name: Chris Lawrence
Title: Fire Chief
Phone: (775) 945-2497

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

James Robert Montgomery, AEMT Intermediate Emergency Medical Technician · Hawthorne, NV · NPI 1316865397

NPD (past)

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA number	Laboratory	Certificate	Expires
29D2238469	Mineral County Fire and EMS 418 Mineral Way, Hawthorne, NV 89415	Certificate of waiver	Oct 3, 2027

Medicare participation

Medicare fee-for-service enrollment: Enrolled in NV

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20120503000204	NV	Part B Supplier - Ambulance Service Supplier	3971765280	Practice locations: Hawthorne, NV

National Provider Directory

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Land Ambulance	3416L0300X	12122	NV	Yes

Addresses

Primary practice location

418 Mineral Way
Hawthorne, NV 89415

Mailing address

PO Box 1095
Hawthorne, NV 89415-1095
Phone (775) 353-0769

Other identifiers

Identifier	Type	State	Issuer
003211664	Medicaid	NV

Other names

Mineral County Fire & EMS Doing business as

Other providers in Hawthorne, NV

All providers in Hawthorne, NV · Land Ambulance in Nevada

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 24, 2021. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.