Healthcare Provider Details

I. General information

NPI: 1962499491
Provider Name (Legal Business Name): CASPER PAYLESS DRUG
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

428 S DURBIN ST
CASPER WY
82601-2818
US

IV. Provider business mailing address

428 S DURBIN ST
CASPER WY
82601-2818
US

V. Phone/Fax

Practice location:
  • Phone: 307-265-1914
  • Fax: 307-472-3188
Mailing address:
  • Phone: 307-265-1914
  • Fax: 307-472-3188

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number5200011
License Number StateWY
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number5200011
License Number StateWY

VIII. Authorized Official

Name: IRIS C HARNAGEL
Title or Position: OWNER PHARMACY MANAGER
Credential: RPH
Phone: 307-265-1914