Healthcare Provider Details

I. General information

NPI: 1689691503
Provider Name (Legal Business Name): COUNTY OF FREMONT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2006
Last Update Date: 05/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 N 2ND ST RM 350
LANDER WY
82520-2302
US

IV. Provider business mailing address

450 N 2ND ST RM 350
LANDER WY
82520-2302
US

V. Phone/Fax

Practice location:
  • Phone: 307-332-1073
  • Fax: 307-332-1064
Mailing address:
  • Phone: 307-332-1073
  • Fax: 307-332-1064

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. JO ANN HEHR
Title or Position: ADMINISTRATIVE EXECUTIVE
Credential:
Phone: 307-856-6979