Healthcare Provider Details

I. General information

NPI: 1285564484
Provider Name (Legal Business Name): MEMORIAL HOSPITAL OF SWEETWATER COUNTY DIALYSIS UNIT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1180 COLLEGE DR
ROCK SPRINGS WY
82901-5863
US

IV. Provider business mailing address

PO BOX 1359
ROCK SPRINGS WY
82902-1359
US

V. Phone/Fax

Practice location:
  • Phone: 307-352-8216
  • Fax: 307-352-8210
Mailing address:
  • Phone: 307-352-8452
  • Fax: 307-352-8155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0700X
TaxonomyEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. TAMI LOVE
Title or Position: CFO
Credential:
Phone: 307-352-8413