Healthcare Provider Details

I. General information

NPI: 1720175920
Provider Name (Legal Business Name): BIG HORN DRUG
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

513 GREYBULL AVE
GREYBULL WY
82426-2038
US

IV. Provider business mailing address

PO BOX 232
GREYBULL WY
82426-0232
US

V. Phone/Fax

Practice location:
  • Phone: 307-765-4601
  • Fax: 307-765-4600
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number5202661
License Number StateWY
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: RONALD WENDLING
Title or Position: OWNER
Credential:
Phone: 307-765-4601