Healthcare Provider Details

I. General information

NPI: 1285657007
Provider Name (Legal Business Name): NORTH LINCOLN COUNTY HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 01/12/2021
Certification Date: 01/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 ADAMS
AFTON WY
83110-0579
US

IV. Provider business mailing address

PO BOX 579
AFTON WY
83110-0579
US

V. Phone/Fax

Practice location:
  • Phone: 307-885-5800
  • Fax: 307-885-5865
Mailing address:
  • Phone: 307-885-5800
  • Fax: 307-885-5865

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number01
License Number StateWY

VIII. Authorized Official

Name: DEIRDRE HEBDON
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 307-885-5811