Healthcare Provider Details

I. General information

NPI: 1174524607
Provider Name (Legal Business Name): HOT SPRINGS COUNTY HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2005
Last Update Date: 09/04/2024
Certification Date: 09/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

156 N. 6TH STREET
BASIN WY
82410-0388
US

IV. Provider business mailing address

PO BOX 388 156 N 6TH STREET
BASIN WY
82410-0388
US

V. Phone/Fax

Practice location:
  • Phone: 307-568-2499
  • Fax: 307-568-2699
Mailing address:
  • Phone: 307-568-2499
  • Fax: 307-568-2699

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number5946A
License Number StateWY
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateWY

VIII. Authorized Official

Name: NATALYA KELLER
Title or Position: CFO
Credential:
Phone: 307-864-5065