MEDICARE: INTERIM HEALTHCARE OF WYOMING, INC.

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	163WC1500X	Community Health Registered Nurse	RN5466	MT
2	163WH0200X	Home Health Registered Nurse	RN5466	MT
3	164W00000X	Licensed Practical Nurse	LPN5577	MT
4	251E00000X	Home Health Agency
5	251J00000X	Nursing Care Agency	RN5466	MT
6	372500000X	Chore Provider
7	372600000X	Adult Companion
8	373H00000X	Day Training/Habilitation Specialist
9	3747A0650X	Attendant Care Provider
10	3747P1801X	Personal Care Attendant
11	374U00000X	Home Health Aide
12	376J00000X	Homemaker
13	376K00000X	Nurse's Aide

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1922167915
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTERIM HEALTHCARE OF WYOMING, INC.

Provider Business Mailing Address
First Line	:	3316 2ND AVE N
Second Line	:
City	:	BILLINGS
State	:	MT
Zip	:	59101-2005
Country	:	US
Telephone Number	:	406-252-8794
Fax Number	:	406-248-6575

Provider Business Practice Location Address
First Line	:	3316 2ND AVE N
Second Line	:
City	:	BILLINGS
State	:	MT
Zip	:	59101-2005
Country	:	US
Telephone Number	:	406-252-8794
Fax Number	:	406-248-6575

Authorized Official
Title or Position	:	MANAGER
Name	:	MS. BETH A MONTGOMERY
Credential	:
Telephone Number	:	406-252-8794

Provider Enumeration Date	:	12/06/2006
Last Update Date	:	09/11/2025

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