Healthcare Provider Details
I. General information
NPI: 1942921937
Provider Name (Legal Business Name): WEST PARK HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/07/2022
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
PO BOX 143
BASIN WY
82410-0143
US
IV. Provider business mailing address
707 SHERIDAN AVE
CODY WY
82414-3409
US
V. Phone/Fax
- Phone: 307-568-3700
- Fax: 307-586-2217
- Phone: 307-527-7501
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QR1300X |
| Taxonomy | Rural Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
HANNAH
HANNAH
MCRAE
Title or Position: CEO
Credential:
Phone: 307-578-2490