Healthcare Provider Details

I. General information

NPI: 1891861902
Provider Name (Legal Business Name): ABOVE PAR PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 04/03/2023
Certification Date: 04/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 E LAKEWAY RD SUITE A
GILLETTE WY
82718-6416
US

IV. Provider business mailing address

PO BOX 1202
GILLETTE WY
82717-1202
US

V. Phone/Fax

Practice location:
  • Phone: 307-685-6985
  • Fax: 307-685-6988
Mailing address:
  • Phone: 307-670-0464
  • Fax: 307-459-6965

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateWY
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number5203562
License Number StateWY

VIII. Authorized Official

Name: SUSAN HOOKER
Title or Position: PHARMACIST OWNER
Credential: RPH
Phone: 307-685-6985