MEDICARE: ARRANTS PEMBROKE PC

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	152W00000X	Optometrist

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	:	1912099433
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARRANTS PEMBROKE PC

Provider Business Mailing Address
First Line	:	PO BOX 2250
Second Line	:
City	:	ROCK SPRINGS
State	:	WY
Zip	:	82902-2250
Country	:	US
Telephone Number	:	307-382-4444
Fax Number	:

Provider Business Practice Location Address
First Line	:	2820 FOOTHILL BLVD
Second Line	:
City	:	ROCK SPRINGS
State	:	WY
Zip	:	82901-4836
Country	:	US
Telephone Number	:	307-382-4444
Fax Number	:

Authorized Official
Title or Position	:	OPTOMETRIST SECRETARY
Name	:	DR. ALISON ARRANTS
Credential	:	O.D.
Telephone Number	:	307-382-4444

Provider Enumeration Date	:	09/29/2006
Last Update Date	:	10/30/2015

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