Healthcare Provider Details

I. General information

NPI: 1891890034
Provider Name (Legal Business Name): COUNTY OF BIG HORN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 06/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

417 S 2ND ST
GREYBULL WY
82426-2235
US

IV. Provider business mailing address

417 S 2ND ST
GREYBULL WY
82426-2235
US

V. Phone/Fax

Practice location:
  • Phone: 307-765-2371
  • Fax: 307-765-2381
Mailing address:
  • Phone: 307-765-2371
  • Fax: 307-765-2381

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number08-082
License Number StateWY
# 2
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number08-082
License Number StateWY

VIII. Authorized Official

Name: SUSAN WILEY
Title or Position: NURSING MANAGER
Credential: RN, BSN
Phone: 307-765-2371