MEDICARE: WIND RIVER FAMILY & COMMUNITY HEALTHC CARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP0904X	Federal Public Health Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285006379
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WIND RIVER FAMILY & COMMUNITY HEALTHC CARE

Provider Business Mailing Address
First Line	:	PO BOX 1310
Second Line	:
City	:	RIVERTON
State	:	WY
Zip	:	82501-0158
Country	:	US
Telephone Number	:	307-856-9281
Fax Number	:	307-316-0348

Provider Business Practice Location Address
First Line	:	14 GREAT PLAINS ROAD
Second Line	:
City	:	ARAPAHOE
State	:	WY
Zip	:	82510-0014
Country	:	US
Telephone Number	:	307-856-9281
Fax Number	:	307-316-0348

Authorized Official
Title or Position	:	CEO
Name	:	RICHARD B. BRANNAN
Credential	:
Telephone Number	:	307-856-9281

Provider Enumeration Date	:	10/28/2015
Last Update Date	:	01/22/2025

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