Healthcare Provider Details

I. General information

NPI: 1104976372
Provider Name (Legal Business Name): US HEALTH DEPT OF HEALTH & HUMAN SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 05/24/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 GREAT PLAINS ROAD
ARAPAHOE WY
82501
US

IV. Provider business mailing address

PO BOX 1310 14 GREAT PLAINS RD ARAPAHOE WY 82501
RIVERTON WY
82501-0158
US

V. Phone/Fax

Practice location:
  • Phone: 307-856-9281
  • Fax: 307-856-1630
Mailing address:
  • Phone: 307-856-9281
  • Fax: 307-856-1630

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP0904X
TaxonomyFederal Public Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. MICHELLE ANTONE
Title or Position: ACTING CEO/ADMINISTRATIVE OFFICER
Credential:
Phone: 307-332-7300