Healthcare Provider Details

I. General information

NPI: 1336265255
Provider Name (Legal Business Name): NOYES HEALTH CARE CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 04/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 WHIPPOORWILL STREET
BAGGS WY
82321-0307
US

IV. Provider business mailing address

PO BOX 307 305 WHIPPOORWILL STREET
BAGGS WY
82321-0307
US

V. Phone/Fax

Practice location:
  • Phone: 307-383-7000
  • Fax: 307-383-7005
Mailing address:
  • Phone: 307-383-7000
  • Fax: 307-383-7005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number4
License Number StateWY

VIII. Authorized Official

Name: RONALD K TAYLOR
Title or Position: SUPERVISOR
Credential: PAC
Phone: 307-383-7000