Healthcare Provider Details

I. General information

NPI: 1467939918
Provider Name (Legal Business Name): SOUTH LINCOLN HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2018
Last Update Date: 07/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 ONYX ST
KEMMERER WY
83101-3214
US

IV. Provider business mailing address

711 ONYX ST
KEMMERER WY
83101-3214
US

V. Phone/Fax

Practice location:
  • Phone: 307-877-4401
  • Fax: 307-877-3236
Mailing address:
  • Phone: 307-877-4401
  • Fax: 307-877-3236

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: KRISTIN HOUSLEY
Title or Position: COMPTROLLER
Credential:
Phone: 307-877-4401