Healthcare Provider Details

I. General information

NPI: 1285006379
Provider Name (Legal Business Name): WIND RIVER FAMILY & COMMUNITY HEALTHC CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2015
Last Update Date: 01/22/2025
Certification Date: 11/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 GREAT PLAINS ROAD
ARAPAHOE WY
82510-0014
US

IV. Provider business mailing address

PO BOX 1310
RIVERTON WY
82501-0158
US

V. Phone/Fax

Practice location:
  • Phone: 307-856-9281
  • Fax: 307-316-0348
Mailing address:
  • Phone: 307-856-9281
  • Fax: 307-316-0348

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: RICHARD B. BRANNAN
Title or Position: CEO
Credential:
Phone: 307-856-9281