Healthcare Provider Details

I. General information

NPI: 1649660671
Provider Name (Legal Business Name): WESTON COUNTY HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2015
Last Update Date: 11/18/2025
Certification Date: 11/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1124 WASHINGTON BLVD
NEWCASTLE WY
82701-2972
US

IV. Provider business mailing address

727A WASHINGTON BLVD
NEWCASTLE WY
82701-2930
US

V. Phone/Fax

Practice location:
  • Phone: 307-746-2425
  • Fax: 307-746-9263
Mailing address:
  • Phone: 307-746-2425
  • Fax: 307-746-9263

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberR10140
License Number StateWY

VIII. Authorized Official

Name: TAVIS WEIDENBACH
Title or Position: DIRECTOR OF PHARMACY/AO
Credential:
Phone: 307-746-3742