Healthcare Provider Details

I. General information

NPI: 1922271386
Provider Name (Legal Business Name): CAMPBELL COUNTY HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2008
Last Update Date: 12/05/2022
Certification Date: 12/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 S BURMA AVE
GILLETTE WY
82716-3426
US

IV. Provider business mailing address

500 ROSS ST 154-0455 PO BOX 392967
PITTSBURGH PA
15251-9967
US

V. Phone/Fax

Practice location:
  • Phone: 307-688-9255
  • Fax: 307-688-9256
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number StateWY

VIII. Authorized Official

Name: GERARD DENNIS KLEIN
Title or Position: COO
Credential:
Phone: 307-688-1520