MEDICARE: PRAIRIE HEART CARE CO LLC

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	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1578493920
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRAIRIE HEART CARE CO LLC

Provider Business Mailing Address
First Line	:	6958 WILD BILL CT
Second Line	:
City	:	CHEYENNE
State	:	WY
Zip	:	82001-8557
Country	:	US
Telephone Number	:	307-287-3423
Fax Number	:

Provider Business Practice Location Address
First Line	:	6958 WILD BILL CT
Second Line	:
City	:	CHEYENNE
State	:	WY
Zip	:	82001-8557
Country	:	US
Telephone Number	:	307-287-3423
Fax Number	:

Authorized Official
Title or Position	:	COOWNER
Name	:	DAKOTA A FOSTER
Credential	:	RN
Telephone Number	:	307-287-3423

Provider Enumeration Date	:	05/19/2026
Last Update Date	:	05/19/2026

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Directions to “PRAIRIE HEART CARE CO LLC ” Practice Location

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